Camkk-beta as a target for treating cancer

ABSTRACT

Provided herein are compounds, compositions, including pharmaceutical compositions, having anti-cancer activity. Also provided are methods for diagnosing, detecting, and treating cancer in a subject, as well as a method for evaluating cancer stage in a subject, wherein the methods include determining the amount of a Ca 2+ /calmodulin dependent kinase kinase (CaMKK) in a sample. Further provided are methods of screening and identifying a compound that inhibits CaMKK.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is related to and claims the benefit of priority toU.S. Provisional Patent application Ser. No. 61/374,106, filed Aug. 16,2010, and U.S. Provisional Patent application Ser. No. 61/379,226, filedSep. 1, 2010. The content of both applications are incorporated hereinby reference.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH

This work was supported in part by grants R01 CA139818 (U.S. NationalInstitutes of Health, National Cancer Institute); 1K01 DK084205 (U.S.National Institutes of Health, National Institute of Diabetes andDigestive and Kidney Diseases), and R01 GM033976 (U.S. NationalInstitutes of Health, National Institute of General Medical Sciences).The United States government has certain rights in this invention.

FIELD

The disclosure relates to cancer, including diagnostic markers ofcancer, methods for the diagnosis of cancer, methods and compounds forthe treatment of cancer, methods for identifying cancer stage in asubject, methods for identifying a cancer that is responsive toparticular therapies, and methods for evaluating efficacy of cancertherapy.

SEQUENCE LISTING

An electronic version of the sequence listing(“028193_(—)9098_SeqList.txt”) which is 233,472 bytes in size andcreated on Aug. 16, 2011, is submitted herewith and is hereinincorporated by reference.

BACKGROUND

Prostate cancer is the most common malignancy in men and is second onlyto lung cancer in terms of cancer mortalities [Cancer Facts and Figures:American Cancer Society; 2007.]. Early diagnosis of prostate cancerusually allows for successful surgical treatment of localized tumors andthus, good patient outcomes. However, as with many cancers, thetreatment of the advanced disease state requires a systemic approach toinhibit the growth and spread of secondary metastases. Prostate cancersexpress the androgen receptor (AR) and rely on androgens for growth andsurvival [Isaacs J T, Isaacs W B., Nat Med 2004; 10:26-7]. Consequently,androgen ablation therapies are the standard of care for late-stagedisease. While 80% of patients with prostate cancer respond favorably toinitial androgen ablation therapy, most patients experience a relapse ofthe disease within 1-2 years [Isaacs J T, Isaacs W B., Nat Med 2004;10:26-7.]. Despite the unresponsiveness of the hormone-refractorydisease to androgen-deprivation therapy, AR-regulated signaling pathwaysremain active and are necessary for cancer progression [Chen C. D., etal., Nature Med 2004; 10:33-9.].

Several approaches are currently used to target the AR signaling axis inprostate cancer. Existing therapies focus on decreasing the levels ofcirculating androgens and/or competitively blocking the ARtranscriptional complex. Specifically, gonadotropin-releasing hormone(GnRH) agonists are used to suppress the testicular production oftestosterone whereas antiandrogens, such as bicalutamide, function bycompetitively inhibiting the interaction of androgens with AR. Theinitial response to either form of androgen deprivation is very high.Nevertheless, the rapid onset of resistance to these interventionshighlights the need for other strategies that target thehormone-independent activities of AR.

Most of the studies on the role of androgens in prostate cancer havefocused on defining the mechanisms underlying the mitotic actions ofthis class of hormone [Balk S. P., Nucl Recept Signal 2008; 6:e001].However, there is a growing body of evidence that AR signaling alsoinfluences tumor cell migration and invasion. For example, differentclinical trials of goserelin (a GnRH analog) in prostate cancer patientsdemonstrate reduced incidences of distant metastases [Lawton C. A., etal. Int J Radiation Oncology Biol Phys 2001; 49:937-46; Bolla M., et al.The Lancet 2002; 360:103-8.]. Furthermore, it has recently been reportedthat MDV3100, a second generation AR-antagonist, decreases the number ofcirculating tumor cells in approximately half of the treated patientshaving a castration-resistant type cancer [Scher H. I., et al. TheLancet; 375:1437-46].

Compounds of Formula I are known and have been used as dye molecules.See, for example, U.S. Pat. No. 2,820,037 which describes:

wherein R₁ is selected from CN, COOH, or COCl. The dye industry hasgenerated a number of compounds that are structurally related to thoseof Formula I. See, e.g., U.S. Pat. Nos. 2,835,674; 2,965,644; 2,949,467;3,953,452; 3,960,867; 4,239,868; and 4,336,383.

Japanese Patent Application No. 2003-012516 (Sumitomo PharmaceuticalCo.) identifies compounds as Ca²⁺/calmodulin dependent kinase kinase(CaMKK) inhibitors. The compounds are described as Formula II:

wherein R₁ and R₂ are independently selected from H, halo, alkyl, orhaloalkyl; and R₃ is H, alkyl, or substituted alkyl, or three COOR₃groups can be substituted at any location on the naphthalene ring.

U.S. Patent Application Publication No. 2010/0105716 discloses methodsof treating obesity, insulin resistance, and hyperglycemia byadministering a CaMKK inhibitor compound of Formula III:

wherein R₁, R₂, R₃, R₄, R₅, R₆, R₇, R_(7a), R₈, R₉, R₁₀, and R₁₁ areeach independently selected from the group consisting of H, alkyl,alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkenyl,cycloalkylalkynyl, heterocyclo, heterocycloalkyl, heterocycloalkenyl,heterocycloalkynyl, aryl, arylalkyl, arylalkenyl, arylalkynyl,heteroaryl, heteroarylalkyl, heteroarylalkenyl, heteroarylalkynyl,alkoxy, halo, mercapto, azido, cyano, formyl, carboxylic acid, hydroxyl,nitro, acyl, aryloxy, alkylthio, amino, alkylamino, arylalkylamino,disubstituted amino, acylamino, acyloxy, ester, amide, sulfoxyl,sulfonyl, sulfonate, sulfonic acid, sulfonamide, urea, alkoxylacylamino,and aminoacyloxy; or a pharmaceutically acceptable salt or prodrugthereof.

None of these documents disclose or suggest that any of the compounds ofFormula I-III would be useful in methods relating to cancer, or thatCaMKKβ represents a therapeutic target in the treatment of cancers.

SUMMARY OF THE INVENTION

In an aspect, the disclosure provides a method of diagnosing prostatecancer in a subject comprising: determining an amount of at least one ofCaMKKβ, CaMKKβ splice variant 2, CaMKKβ splice variant 7, phosphorylatedAMPK, phosphorylated AMPKα1 subunit, and phosphorylated AMPKα2 subunitin a sample from the subject; and comparing the amount to a controlsample comprising an amount of CaMKKβ, CaMKKβ splice variant 2, CaMKKβsplice variant 7, phosphorylated AMPK, phosphorylated AMPKα1 subunit,and phosphorylated AMPKα2 subunit in a control sample; wherein thesubject is diagnosed as having prostate cancer when the amount of atleast one of CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splice variant 7,phosphorylated AMPK, phosphorylated AMPKα1 subunit, and phosphorylatedAMPKα2 subunit in the sample from the subject is greater than the amountin the control sample.

In an aspect the disclosure relates to a method for determining diseasestage in a subject having prostate cancer, the method comprising:determining an amount of at least one of CaMKKβ, CaMKKβ splice variant2, CaMKKβ splice variant 7, phosphorylated AMPK, phosphorylated AMPKα1subunit, and phosphorylated AMPKα2 subunit in a sample from the subject;and comparing the amount to a control sample comprising an amount of atleast one of CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splice variant 7,phosphorylated AMPK, phosphorylated AMPKα1 subunit, and phosphorylatedAMPKα2 subunit; wherein the disease stage of prostate cancer isdetermined by the difference in the amount of at least one of CaMKKβ,CaMKKβ splice variant 2, CaMKKβ splice variant 7, phosphorylated AMPK,phosphorylated AMPKα1 subunit, and phosphorylated AMPKα2 subunit in thesample from the subject and the amount in the control sample.

Aspects also relate to a method for predicting the likelihood of successof hormone-based therapeutic treatment of a subject having prostatecancer, the method comprising determining an amount of at least one ofCaMKKβ, CaMKKβ splice variant 2, CaMKKβ splice variant 7, phosphorylatedAMPK, phosphorylated AMPKα1 subunit, and phosphorylated AMPKα2 subunitin a sample from the subject; and comparing the amount to a controlsample comprising an amount of the CaMKKβ, CaMKKβ splice variant 2,CaMKKβ splice variant 7, phosphorylated AMPK, phosphorylated AMPKα1subunit, and phosphorylated AMPKα2 subunit. Embodiments provide for alikely successful response to hormone-based therapeutic treatment whenthe amount of at least one of CaMKKβ, CaMKKβ splice variant 2, CaMKKβsplice variant 7, phosphorylated AMPK, phosphorylated AMPKα1 subunit,and phosphorylated AMPKα2 subunit in the sample from the subject isgreater than the amount in the control sample.

In an aspect the disclosure relates to a method for early detection ofprostate cancer in a subject comprising obtaining a sample from thesubject; determining an amount of at least one of CaMKKβ, CaMKKβ splicevariant 2, CaMKKβ splice variant 7, phosphorylated AMPK, phosphorylatedAMPKα1 subunit, and phosphorylated AMPKα2 subunit in the sample from thesubject; and comparing the amount of at least one of CaMKKβ, CaMKKβsplice variant 2, CaMKKβ splice variant 7, phosphorylated AMPK,phosphorylated AMPKα1 subunit, and phosphorylated AMPKα2 subunit fromthe sample from the subject to an amount of the CaMKKβ, CaMKKβ splicevariant 2, CaMKKβ splice variant 7, AMPK, and AMPK α1 subunit in acontrol sample; wherein early detection of prostate cancer is made whenthe amount of at least one of CaMKKβ, CaMKKβ splice variant 2, CaMKKβsplice variant 7, phosphorylated AMPK, phosphorylated AMPKα1 subunit,and phosphorylated AMPKα2 subunit in the sample from the subject isgreater than the amount in the control sample.

In another aspect the disclosure provides a method for identifying aselective inhibitor of CaMKKβ where the method includes contactingCaMKKβ and a substrate therefor, in the presence and in the absence ofthe test compound, under conditions such that CaMKKβ-dependentphosphorylation of the substrate can be effected, and determining thelevel of phosphorylation of the substrate resulting from the contacting,and comparing the amount of phosphorylated substrate with a level ofphosphorylation of the substrate in the absence of the test compound,wherein an decrease in phosphorylation of the substrate in the presenceof the test compound indicates that the test compound is a selectiveinhibitor of CaMKKβ.

In an aspect the disclosure provides a method of screening a testcompound for anti-cancer activity comprising: contacting CaMKKβ and asubstrate therefor in the presence of the test compound, underconditions that allow for CaMKKβ-dependent phosphorylation of thesubstrate; determining the level of phosphorylation of the substrateresulting from the contacting; and comparing that level with a level ofphosphorylation of the substrate obtained in the absence of the testcompound, wherein a reduction in the level of phosphorylation of thesubstrate in the presence of the test compound indicates that the testcompound has anti-cancer activity.

In an aspect the disclosure provides a method of treating cancer in asubject, comprising administering to the subject an effective amount ofa compound that inhibits activity of a CaMK biological cascade in thesubject.

In an aspect the disclosure provides a method of treating cancer in asubject, comprising administering to the subject an effective amount ofa compound that inhibits activity of at least one of CaMKK or AMPK.

In an aspect the disclosure provides a method of treating cancer in asubject, comprising administering to the subject an effective amount ofa compound that inhibits activity of at least one of CaMKKβ, CaMKKβsplice variant 2, or CaMKKβ splice variant 7.

In a further aspect the disclosure provides a method of treatingprostate cancer in a subject, comprising administering to the subject aneffective amount of a compound that inhibits activity of a CaMKbiological cascade in the subject.

In a further aspect the disclosure provides a method of treatingprostate cancer in a subject, comprising administering to the subject aneffective amount of a compound that inhibits activity of at least one ofCaMKK or AMPK.

In a further aspect the disclosure provides a method of treatingprostate cancer in a subject, comprising administering to the subject aneffective amount of a compound that inhibits activity of at least one ofCaMKKβ, CaMKKβ splice variant 2, or CaMKKβ splice variant 7.

In yet another aspect, the disclosure relates to a method of treatingprostate cancer in a subject, the method comprising administering to thesubject an effective amount of an inhibitor of phosphorylated AMPK,phosphorylated AMPKα1 subunit, or phosphorylated AMPKα2 subunit.

In another aspect, the disclosure provides a method of determining theefficacy of therapy in a patient being treated for prostate cancer, themethod comprising: determining an amount of at least one of CaMKKβ,CaMKKβ splice variant 2, CaMKKβ splice variant 7, phosphorylated AMPK,phosphorylated AMPKα1 subunit, and phosphorylated AMPKα2 subunit in aseries of samples from the subject, where the samples are taken from thesubject at different time points during the therapy; and comparing thedetermined amount over the course of the time points; wherein when theamount of at least one of CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splicevariant 7, phosphorylated AMPK, phosphorylated AMPKα1 subunit, andphosphorylated AMPKα2 in the series of samples is about the same orincreases over the course of the time points, the therapy is noteffective.

In an aspect the disclosure provides a method of inhibitingandrogen-mediated migration of a prostate cancer cell in a subjectcomprising administering to the subject an effective amount of acompound that inhibits activity of a CaMK biological cascade in thesubject.

In an aspect the disclosure provides a method of inhibitingandrogen-mediated migration of a prostate cancer cell in a subjectcomprising administering to the subject an effective amount of acompound that inhibits activity of at least one of CaMKK or AMPK.

In another aspect the disclosure provides a method of inhibitingandrogen-mediated migration of a prostate cancer cell in a subjectcomprising administering to the subject an effective amount of aninhibitor of at least one of CaMKKβ, CaMKKβ splice variant 7, or CaMKKβsplice variant 2 or any combination thereof.

In an aspect the disclosure provides a method of inhibitingandrogen-mediated invasion of a prostate cancer cell in a subjectcomprising administering to the subject an effective amount of acompound that inhibits activity of a CaMK biological cascade in thesubject.

In an aspect the disclosure provides a method of inhibitingandrogen-mediated invasion of a prostate cancer cell in a subjectcomprising administering to the subject an effective amount of acompound that inhibits activity of at least one of CaMKK or AMPK.

In an aspect the disclosure provides a method of inhibitingandrogen-mediated invasion of a prostate cancer cell in a subjectcomprising administering to the subject an effective amount of aninhibitor of at least one of CaMKKβ, CaMKKβ splice variant 7, or CaMKKβsplice variant 2 or any combination thereof.

In an aspect the disclosure provides a method of inhibiting metastasisof prostate cancer in a subject comprising administering to the subjectan effective amount of a compound that inhibits activity of a CaMKbiological cascade in the subject.

In an aspect the disclosure provides a method of inhibiting metastasisof prostate cancer in a subject comprising administering to the subjectan effective amount of a compound that inhibits activity of at least oneof CaMKK or AMPK.

In an aspect the disclosure provides a method of inhibiting metastasisof prostate cancer in a subject comprising administering to the subjectan effective amount of an inhibitor of at least one of CaMKKβ, CaMKKβsplice variant 7, or CaMKKβ splice variant 2 or any combination thereof.

Aspects also relate to a nucleic acid molecule comprising a sequencethat binds under stringent conditions to a region that is about 2.3 kbupstream (5′) relative to a CaMKKβ transcriptional start site.

Further aspects relate to an antibody that specifically binds to aC-terminal portion of a CaMKKb.

Aspects also relate to polynucleotides (e.g., siRNA) that comprise asequence that is complementary to CaMKKβ, CaMKKα, or AMPK and havingkinase-inhibitory activity.

The disclosure provides for and encompasses additional aspects andembodiments, which will be apparent to those of skill in the art inlight of the following description.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1. Androgens increase CaMKKβ levels in an AR-dependent manner.LNCaP or VCaP cells were treated for 24 h with vehicle or increasingconcentrations of the synthetic androgen R1881 (A-0.1, 1, and 10 nM;B-0.01, 0.1, 1, and 10 nM). A, after treatment, cells were lysed, andRNA was isolated and reversed transcribed. The expression of CaMKKβ wasassessed using qPCR. B, after treatment, cells were subjected to westernblot analysis and subsequent densitometry (top). CaMKKβ protein levelswere normalized to GAPDH loading control. A and B, results are expressedas fold induction over vehicle-treated cells+SE (n=3). *, significantchanges from vehicle-treated cells. C, LNCaP cells were transientlytransfected with mock or Stealth siRNAs targeting a negative control(siLacZ) or CaMKKβ (#1-3). Two days later, cells were treated for 24h+/−10 nM R1881. Whole-cell extracts were subjected to western blotanalysis and densitometry (top) as described in B. *, significantchanges from mock-transfected cells. D, LNCaP cells were transfected asdescribed in C with mock or Stealth siRNAs targeting LacZ or AR andtreated for 24 h. The expression of CaMKKβ was assessed as in A usingqPCR.

FIG. 2. Validation of CaMKKβ protein bands. For CaMKKβ western blotanalysis, a different monoclonal CaMKKβ antibody (clone 1A11) was usedthan in FIG. 1. CaMKKβ protein levels were normalized to GAPDH loadingcontrol. Results are expressed as fold induction over vehicle-treatedcells+SE (n=2). *, P<0.05 indicates significant changes frommock-transfected cells.

FIG. 3. CaMKKβ levels are increased in prostate cancer samples.Independent microarrays were analyzed using the Oncomine resource. A,four separate studies determined that CaMKKβlevels were elevated inprostate cancer samples (red) compared to normal prostate controls(blue). B, CaMKKβ levels correlated with disease progression. C, CaMKKβlevels are significantly higher in prostate cancer samples compared toother cancers (a-bladder, b-kidney, c-colon, d-breast, e-esophageal,f-liver, g-lung, h-ovarian, i-pancreatic, j-squamous cell lung). Allchanges in expression were at the P<0.001 level.

FIG. 4. The prostate expresses a different functional splice variant ofCaMKKβ compared to brain. A, schematic of CaMKKβ splice variants. B,RT-PCR using primers spanning specific exons (indicated in rightschematic) was performed on cDNA generated from various tissues and celllines. C, LNCaP or VCaP cells were treated for 24 h+/−10 nM R1881. Celllysates were then subjected to western blot analysis and subsequentdensitometry (right). Phospho-CaMKI (p-CaMKI) protein levels werenormalized to total CaMKI. Results are expressed as fold CaMKIphosphorylation over vehicle-treated cells+SE (n=3). *, significantchanges from vehicle-treated cells.

FIG. 5. The prostate expresses different splice variants of CaMKK

compared to brain (expanded FIG. 4A and FIG. 4B). A, schematic of CaMKKβsplice variants. B, RT-PCR using primers spanning specific exon-exonboundaries (indicated in right schematic) was performed on cDNAgenerated from various tissues and cell lines.

FIG. 6. CaMKKβ activity in androgen-mediated cell migration in prostatecancer cells. A, LNCaP cells were pretreated for 1 h with vehicle, 10 or30 mM STO-609 prior to overnight treatment with vehicle, 100 pM or 10 nMR1881. Cell lysates were then subjected to western blot analysis andsubsequent densitometry (right). Phospho-CaMKI (p-CaMKI) levels werenormalized to total CaMKI. Results are expressed as foldinduction/phosphorylation over double vehicle-treated cells+SE (n=2). *,P<0.05 indicates significant changes from vehicle-treated cells. ^(#),P<0.05 indicates significant changes from vehicle (no STO-609)-treatedcells. B, VCaP cells were plated in 96-well plates and grown for 3 d.Cells were treated +/−1 nM R1881 and +/−30 mM STO-609 on d 3, d 5, and d7. On d 10, cells were lysed and the relative number of cells wasmeasured with the fluorescent DNA binding dye FluoReporter Blue. Eachsample was performed in triplicate, and results from a representativeexperiment are shown. Results are expressed as relative cell number ±SE(n=2). *, P<0.05 indicates significant changes from vehicle (noR1881)-treated cells. C, VCaP cells were pretreated for 1 h+/−30 mMSTO-609 prior to overnight treatment +/−10 nM R1881. Cells were thendissociated and reseeded into the top chamber for a Boyden dual chambermigration assay. Fresh medium with the corresponding treatments wasadded to the top and bottom chambers while either no chemoattractant or5% FBS (serum) was added to the bottom chamber. After 16 h, migratedcells were fixed, stained with crystal violet and counted in threedifferent microscopic fields and added together. The results areexpressed as mean±SE (n=2). *, P<0.05 indicates significant changes fromvehicle (no R1881)-treated cells. D and E, densitometry results forwestern blots in FIG. 7C and FIG. 7D respectively. *, P<0.05 indicatessignificant changes from vehicle-treated (D) or GAL4 control (E) cells.^(#), P<0.05 indicates significant changes from control(siLacZ)-transfected cells (D).

FIG. 7. CaMKKβ activity in the androgen-mediated migration and invasionof prostate cancer cells. A, LNCaP cells were plated in 96-well platesand grown for 3 d. Cells were treated +/−1 nM R1881 and +/−30 mM STO-609on d 3, d 5, and d 7. On d 10, cells were lysed and the relative numberof cells was measured with the fluorescent DNA binding dye FluoReporterBlue. Each sample was performed in triplicate, and results from arepresentative experiment are shown. Results are expressed as relativecell number ±SE (n=2). *, significant changes from vehicle (noR1881)-treated cells. B, LNCaP cells were pretreated for 1 h+/−30 mMSTO-609 prior to overnight treatment+/−10 nM R1881. Cells were thendissociated and reseeded into the top chamber for a Boyden migration orMatrigel extracellular matrix invasion assay. Fresh medium with thecorresponding treatments was added to the top and bottom chambers whileeither no chemoattractant or 5% FBS (serum) was added to the bottomchamber. After 16 h, migrated cells were fixed, stained and counted inthree different microscopic fields and added together. The results areexpressed as mean±SE (n=3). *, significant changes from vehicle (noR1881)-treated cells. ⁴, significant changes from vehicle (noSTO-609)-treated cells. C top, LNCaP cells were transfected withindicated siRNAs. Two days after transfection, cells were treated +/−10nM R1881 and subjected to a Boyden migration assay as described in B. *,significant changes from vehicle-treated cells. ⁴, significant changesfrom control (siLacZ)-transfected cells. C bottom, western blot todemonstrate CaMKKβ knockdown. Quantification of these blots is presentedin FIG. 6D. D right, LNCaP cells stably expressing either GAL4 (control)or CaMKKβ were subjected to a migration assay as described in B using+/−5% FBS as chemoattractant. The results are expressed as mean±SE(n=3). *, significant changes from LNCaP-GAL4 cells. D left, westernblot confirming CaMKK

expression. Quantification of these blots is presented in FIG. 6E.

FIG. 8. Androgen mediated prostate cancer cell migration and functionalAR-mediated transcription. A and B, an example of the AR replacementstrategy is shown. This method has the advantage of using cells withendogenous androgen signaling as opposed to the common reintroducing ofAR into AR-negative cells, which often has artificial biologicalconsequences. Here, cells that express endogenous AR, in this caseLNCaPs, were retrovirally infected to create stable cell linesexpressing a control (GAL4) or a v5-tagged version of AR (wild type or aDNA-binding domain mutant (C562S)) linked to an IRES-EGFP. Cells werethen selected using 2 rounds of flow cytometry. Subsequently,EGFP-positive cells were transfected with chemical siRNAs targetingeither a control sequence (siLacZ) or the 3′-UTR of AR (eliminatesendogenous receptor). A, a western blot characterization of theresultant cell lines is shown at the right using antibodies for v5(recognizes only exogenous AR), AR (recognizes both exogenous andendogenous AR) or GAPDH (loading control). B, LNCaP cells used in the ARreplacement experiments were also subjected to qPCR analysis usingprimers targeting the AR 3′UTR (monitors endogenous AR levels). Theexpression of AR was normalized to 36B4 levels and results are expressedas relative mRNA levels of AR compared to mock-transfected cells+SE(n=2). *, P<0.05 indicates significant changes from mock-transfectedcells. C, cells were then subjected to a migration assay as described inFIG. 9. *, P<0.05 indicates significant changes from vehicle-treatedcells.

FIG. 9. Identification of the ARE that regulates CaNIKKβ expression. A,LNCaP cells were pretreated for 1 h with vehicle or 1 mg/mLcycloheximide followed by vehicle or 10 nM R1881 for 24 h. CaMKKβ orCXCR4 mRNA levels were quantified using qPCR. Results are expressed asfold induction over vehicle (no R1881)-treated cells ±SE (n=3). *,significant changes from vehicle-treated cells. B, LNCaP cells weretreated with vehicle (V) or 10 nM R1881 for 1 or 4 h. Cross-linkedchromatin was immunoprecipitated with indicated antibodies. Theprecipitated DNA was amplified using primers spanning a regionidentified using ChIP on Chip data as a potential AR-binding site(indicated in top schematic) or a distal upstream region (negativecontrol). The results are presented as percent input ±SE (n=3). *,significant changes from IgG controls. C, various enhancer luciferasereporter constructs (depicted in top model) were transfected into LNCaPcells and treated overnight +/−10 nM R1881. After treatment, cells wereharvested and assayed for luciferase activity. Luciferase values werenormalized to J3-galactosidase control. Data are the mean relative lightunits (RLUs)+SEM for one representative experiment performed intriplicate (n=3). *, significant changes from vehicle-treated cells. D,CaMKKβpromoter constructs (depicted in top model) were transfected intoLNCaP cells and then treated overnight with vehicle or 10 nM R1881.After treatment, cells were harvested and assayed for luciferaseactivity as in C. Emp Vec, empty vector.

FIG. 10. Identification of the ARE that regulates CaMKKβ expression. A,two CaMKKβ enhancer (fragments D and E from FIG. 9C) luciferase reporterconstructs were transfected into LNCaP cells and then pretreated for 30minutes with vehicle or 10 mM Casodex followed by treatment overnightwith vehicle or various concentrations of R1881 (0, 0.1, 1 and 10 nM).After treatment, cells were harvested and assayed for luciferaseactivity. Luciferase values were normalized to β-galactosidase control.Data are the mean relative light units (RLUs) SEM for one representativeexperiment performed in triplicate (n=3). *, P<0.05 indicatessignificant changes from vehicle (no R1881)-treated cells. ^(#) P<0.05indicates significant changes from vehicle (no Casodex)-treated cells.B, VCaP cells were transfected, treated and assayed for luciferaseactivity as in A using the PSA enhancer and CaMKKβ enhancer fragments Dand E. C, CaMKKβ enhancer deletion constructs were transfected intoLNCaP cells and then treated and assayed for luciferase activity as in A(n=2). Emp Vec, empty vector.

FIG. 11. Androgen-mediated migration occurs through aCaMKKβ-AMPK-dependent pathway. A, LNCaP cells were pretreated for 1h+/−30 mM STO-609 prior to overnight treatment +/−10 nM R1881. Celllysates were then subjected to western blot analysis and subsequentdensitometry (right). CaMKKβ levels were normalized to GAPDH.Phospho-CaMKI (p-CaMKI) levels were normalized to total CaMKI.Phospho-AMPK (p-AMPK) levels were normalized to total AMPK. Results areexpressed as fold induction/phosphorylation over double vehicle-treatedcells+SE (n=3). *, significant changes from vehicle-treated cells. B,LNCaP cells stably expressing either GAL4 or CaMKK

were treated overnight +/−10 nM R1881. Cell lysates were then subjectedas in A to western blot analysis and densitometry (right). Results areexpressed as fold induction/phosphorylation over LNCaP-GAL4vehicle-treated cells+SE (n=3). *, significant changes from LNCaP-GAL4vehicle-treated cells. C and D, LNCaP cells were transfected withindicated siRNAs, treated and subjected to a migration assay (top) orwestern blot analysis (bottom) as in FIG. 7C. *, significant changesfrom control (siLacZ)-transfected cells. Quantification of the blots ispresented in FIG. 12.

FIG. 12. Androgen-mediated migration occurs through aCaMKKβ-AMPK-dependent pathway. A, VCaP cells were treated for 24 h+/−10nM R1881. Cell lysates were then subjected to western blot analysis andsubsequent densitometry (right). Phospho-CaMKI (p-CaMKI) levels werenormalized to total CaMKI. Phospho-AMPK (p-AMPK) levels were normalizedto total AMPK. Results are expressed as fold induction/phosphorylationover vehicle-treated cells+SE (n=2). *, P<0.05 indicates significantchanges from vehicle-treated cells. B, selection of optimal AMPKα1 andα2 siRNAs. LNCaP cells were transfected as described in FIG. 11 withmock or Stealth siRNAs targeting LacZ (negative control) or AMPKα1 orα2. The expression of AMPK was assessed using qPCR and normalized to36B4 levels. Results are expressed as fold induction overmock-transfected cells+SE (n=2). *, P<0.05 indicates significant changesfrom mock-transfected cells. C and D, densitometry results for westernblots in FIG. 11C and FIG. 11D, respectively. For AMPKαknockdown (C),siAMPKα1-#1 and siAMPKα2-#1 from B were selected since they produced thegreatest knockdowns. *, P<0.05 indicates significant changes fromcontrol (siLacZ)-transfected cells.

FIG. 13. AMPK and androgen-mediated prostate cancer cell migration. A,LNCaP cells were pretreated for 1 h with vehicle or increasingconcentrations of compound C (10 or 40 mM) prior to overnight treatment+/−10 nM R1881 or 1 mM AICAR. Cells were then subjected to a migrationassay as described in FIG. 7. The results are expressed as mean±SE(n=2). *, P<0.05 indicates significant changes from doublevehicle-treated cells. ^(#), P<0.05 indicates significant decreases fromvehicle (no compound C)-treated cells. B, LNCaP cells were pretreatedfor 1 h with vehicle, 1, 10 or 40 mM compound C prior to overnighttreatment+/−10 nM R1881. Cell lysates were then subjected to westernblot analysis and subsequent densitometry (top). ACC is a direct targetof AMPK and thus, was used as a readout of AMPK catalytic activity.Phospho-ACC (p-ACC) levels were normalized to total ACC. Results areexpressed as fold induction/phosphorylation over double vehicle-treatedcells +SE (n=2). *, P<0.05 indicates significant changes from doublevehicle-treated cells. C, LNCaP cells were treated overnight +/−1 mMAICAR and then subjected to western blot analysis and densitometry (top)as in B. Phospho-AMPK (p-AMPK) levels were normalized to total AMPK. *,P<0.05 indicates significant changes from vehicle-treated cells.

DETAILED DESCRIPTION

The inventors have identified Ca²⁺/calmodulin-dependent protein kinasekinases (CaMKKs), such as CaMKKβ, as viable targets for therapeuticintervention in various cancers such as, for example, prostate cancer,glioblastoma, and myeloid leukemia as well as other cancer typesdescribed herein. In a general sense, the disclosure provides an arrayof compounds and compositions that are active inhibitors of CaMKK anduse of such compounds in methods relating to detection, determination ofdisease stage/progression, prognostic evaluation of hormone therapy,treatment of disease, identification of active agents against variouscancers, as well as identification of CaMKK inhibitors, includinginhibitors that are selective for a particular CaMKK. For purposes ofillustration some particular aspects and embodiments are explicitlydescribed herein, relating to Ca²⁺/calmodulin-dependent protein kinasekinase β (CaMKKβ) which is shown (a) to be expressed in the prostate,(b) to be regulated by AR, (c) to correspond to prostate cancerprogression/disease stage and, accordingly, provides a therapeutictarget for prostate cancer.

As used herein, the term “Ca²⁺/calmodulin-dependent protein kinasekinase” and/or “CaMKK” are used interchangeably herein and refer to aserine/threonine protein kinase that can phosphorylate and activatemembers of the Ca²⁺/calmodulin-dependent protein kinase (CaMK) family ofenzymes as well as other protein substrates such as AMPK (e.g., SEQ IDNOs: 21-24). The terms encompass all of the various isoforms, orthologs,and splice variants of CaMKK proteins such as, for example,Ca²⁺/calmodulin-dependent protein kinase kinase (3 (CaMKKβ, or CaMKK2)Ca²⁺/calmodulin-dependent protein kinase kinase α (CaMKKα, or CaMKK1),splice variants such as, for example, CaMKKβ splice variants 1-7, CaMKKαsplice variants 1-3, and the like (e.g., SEQ ID NOs: 1-20 and 25-46).Some embodiments relate to CaMKKβ that comprises the amino acid sequenceof SEQ ID NO:2, or a fragment thereof. The CaMKK amino acid sequences,such as CaMKKβ, can be encoded by any appropriate polynucleotidemolecule as determined by the genetic code and codon usage in anyparticular organism. In embodiments, CaMKKβ is encoded by apolynucleotide comprising SEQ ID NO:1, or a fragment thereof. Someembodiments relate to CaMKKα that comprises the amino acid sequence ofSEQ ID NO:16, or a fragment thereof. In some embodiments, CaMKKα likeCaMKKβ above, is encoded by any polynucleotide that can be envisioned byone of skill in the art and, in some embodiments, comprises SEQ IDNO:15, or a fragment thereof.

In some embodiments the disclosure relates to a CaMKK splice variant.Non-limiting examples of CaMKK splice variants include nucleotidesequences of SEQ ID NOs: 3, 5, 7, 9, 11, 13, 17, and 19. Someembodiments relate to “CaMKKβ splice variant 2” and comprise anucleotide sequence of SEQ ID NO:3, or a fragment thereof. Someembodiments relate to “CaMKKβ splice variant 7” and comprise anucleotide sequence of SEQ ID NO:13. In these embodiments, the splicevariant proteins encoded by SEQ ID NO:3 and SEQ ID NO:13 are identicalin sequence. Thus, embodiments of disclosure provide for apolynucleotide that encodes a CaMKKβ splice variant protein comprisingSEQ ID NO:4, or a fragment thereof. Similarly, the disclosure relates topolynucleotide sequences that encodes an amino acid sequence of anyCaMKK or CaMK protein such as, for example those of SEQ ID NOs: 2, 4, 6,8, 10, 12, 14, 16, 18, or 20. As noted above, CaMKKβ splice variant 2and splice variant 7 encode for the same amino acid sequence; thus, inembodiments relating to a CaMKKβ amino acid sequence encoded by splicevariant 2 or splice variant 7, reference to an amino acid sequenceencoded by either splice variant will also encompass the other (i.e.,each term is interchangeable with and inclusive of the other when itrelates to the encoded amino acid sequence).

Any sample can be used in the methods described herein. Embodimentsprovide for the use of a biological sample (e.g., tissue biopsy,cerebrospinal fluid, blood, sera, sputum, urine and/or tumor biopsies)from a subject with and/or without a cancer (which can be determinedusing standard clinical tests).

Embodiments of the disclosure relate to compounds that are inhibitors ofa CaMK biochemical cascade. A CaMK biochemical cascade refers to abiochemical activation pathway that typically involves thephosphorylation of a first Ca²⁺/calmodulin-dependent protein kinase(CaMK) by a second Ca²⁺/calmodulin-dependent protein kinase (thus, aCa²⁺/calmodulin-dependent protein kinase kinase (CaMKK)). Thephosphorylated CaMK can subsequently phosphorylate a substrate. CaMKcascades are described in the literature. See, Corcoran, E. E., andMeans, A. R., J Biol Chem, (Feb. 2, 2001); 276(5):2975-2978,incorporated herein by reference.

Methods of Treatment

In an aspect, the disclosure provides a method for treating cancer in asubject in need thereof comprising administering to the subject aneffective amount of a Ca²⁺/calmodulin-dependent protein kinase kinase(CaMKK) inhibitor. In embodiments, the method comprises administering aneffective amount of a CaMKK inhibitor that is a selective inhibitor ofCaMKKα and/or CaMKKβ. In some embodiments the CaMKK inhibitor is aselective inhibitor of CaMKKα. In some embodiments the CaMKK inhibitoris a selective inhibitor of CaMKKβ. The term “selective inhibitor,”including “selective inhibitor of CaMKKβ/α” or “CaMKKβ/αselectiveinhibitor” relates to a compound (e.g., a small molecule or biologicalmolecule) that has increased inhibitory activity for a target, forexample, CaMKKβ or CaMKKα, relative to the inhibitory activity for otherCaMKs. For purposes of illustration, when describing embodimentscomprising a selective inhibitor of CaMKKβ, examples of “other” CaMKsinclude natural/physiological substrates of CaMKKβ such as, for example,Ca²⁺/calmodulin-dependent protein kinases (e.g., CaMKI and CaMKIV),CaMKs that are not substrates of CaMKKβ (e.g., CaMKII and CaMKIII),AMP-activated protein kinase (e.g., AMPKα1 subunit and AMPKα2 subunit)as well as other kinases that can phosphorylate such substrates(CaMKKα). Embodiments also relate to polypeptide fragments comprising asequence that contains a portion of a CaMKKβ substrate. In suchembodiments, the fragment comprises an amino acid that can bephosphorylated. In some embodiments a selective inhibitor comprises aratio of IC₅₀ concentrations (concentration inhibiting 50% of activity)wherein the ratio of the IC₅₀ concentration for one or more other CaMKsto the IC₅₀ concentration for CaMKKβ is greater than 1. The ratio ofIC₅₀ values can be readily determined from data obtained from one ormore assay(s) (performed separately, in parallel or series) that iseffective to measure activity or abundance of a CaMK or CaMKK (e.g.,phosphorylation, mRNA transcription, protein expression, etc.), and cancomprise any methods known in the art such as, for example thosedisclosed in U.S. Pat. No. 7,105,312, which is incorporated herein byreference. The inhibitory activity can be assessed and demonstratedeither in vivo and/or in vitro optionally in cell-based or cell-freeassay systems.

In general, the CaMKK inhibitor, including a CaMKK selective inhibitor,can be any type of chemical or biological molecule that exhibitsinhibitory activity against one or more CaMKK. Effective CaMKKinhibitors for use in the methods described herein can inhibit thekinase activity of a CaMKK or they can regulate the amount of a CaMKK ina cell. Accordingly, the CaMKK inhibitors can inhibit phosphorylationassociated with a CaMK cascade, and/or regulate expression of a CaMKK(e.g., by inhibiting a CaMKK gene promoter, inhibiting CaMKK genetranscription, inhibiting CaMKK mRNA translation, and/or affect CaMKKmRNA stability).

In some embodiments of this aspect, the method includes at least oneselective inhibitor of CaMKKβ that comprises a compound of Formula III:

wherein R₁, R₂, R₃, R₄, R₅, R₆, R₇, R_(7a), R₈, R₉, R₁₀, and R₁₁ areeach independently selected from the group consisting of H, alkyl,alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkenyl,cycloalkylalkynyl, heterocyclo, heterocycloalkyl, heterocycloalkenyl,heterocycloalkynyl, aryl, arylalkyl, arylalkenyl, arylalkynyl,heteroaryl, heteroarylalkyl, heteroarylalkenyl, heteroarylalkynyl,alkoxy, halo, mercapto, azido, cyano, formyl, carboxylic acid, hydroxyl,nitro, acyl, aryloxy, alkylthio, amino, alkylamino, arylalkylamino,disubstituted amino, acylamino, acyloxy, ester, amide, sulfoxyl,sulfonyl, sulfonate, sulfonic acid, sulfonamide, urea, alkoxylacylamino,aminoacyloxy, and, for the groups R₇ and R_(7a), can optionally be takentogether to form oxo; or a pharmaceutically acceptable salt or prodrugthereof. Such compounds are disclosed in U.S. patent applicationpublication US 2010/0105716, incorporated herein by reference.

In further embodiments R₇ and R_(7a) together form oxo (C═O).

In some embodiments, R₇ and R_(7a) do not form oxo (C═O).

In some embodiments, R₃ is —COOH, —CH₂COOH, —CH₂CH₂COOH, or an esterthereof.

In some embodiments, R₁, R₂, R₄, R₅, R₆, R₇, R_(7a), R₈, R₉, R₁₀, R₁₁are all H.

In some embodiments, at least one, two, or three of R₁, R₂, R₄, R₅, R₆,R₇, R_(7a), R₈, R₉, R₁₀, and R₁₁ is not H. Thus, in some embodiments, R₁is not H; in some embodiments R₂ is not H; in some embodiments R₃ is notH; in some embodiments R₄ is not H; in some embodiments R₅ is not H; insome embodiments R₆ is not H; in some embodiments R₇ is not H; in someembodiments R₉ is not H; in some embodiments R₁₀ is not H; and/or insome embodiments R₁₁ is not H.

Compounds of Formula III, including further definitions of substituentterms and various formulations thereof are disclosed in U.S. PatentApplication Publication No: 2010/0105716 as useful in methods oftreating metabolic diseases/disorders including obesity, insulinresistance, hyperglycemia, diabetes, and the like. Synthetic routes andstrategies for the compounds of Formula III are known in the art. Thedisclosure of US 2010/0105716 is incorporated herein by reference.

Embodiments of this aspect relate to a method comprising a selectiveinhibitor of CaMKKβ of Formula I:

wherein R₁ is selected from CN, COOH, or COCl. Compounds of Formula Iare described in U.S. Pat. No. 2,820,037 for use as dye molecules, andis incorporated herein by reference.

Other embodiments of this aspect relate to a method comprising aselective inhibitor of CaMKKβ of Formula II:

wherein R₁ and R₂ are independently selected from H, halo, alkyl, orhaloalkyl; and R₃ is H, alkyl, or substituted alkyl, or three COOR₃groups can be substituted at any location on the naphthalene ring.Compounds of Formula II are disclosed in Japanese Patent Application No.2003-012516 as Ca²⁺/calmodulin dependent kinase kinase (CaMKK)inhibitors; however the reference fails to disclose the use of thesecompounds as effective in methods relating to cancer. The disclosure ofJapanese Patent Application No. 2003-012516 is incorporated herein byreference.

The compounds of Formulas I-III can be synthesized by any method knownin the art such as, for example, the methods described Japanese PatentApplication No. 2003-012516; U.S. Pat. No. 2,820,037; U.S. Pat. No.2,835,674; U.S. Pat. No. 2,965,644; U.S. Pat. No. 2,949,467; U.S. Pat.No. 3,953,452; U.S. Pat. No. 3,960,867; U.S. Pat. No. 4,239,868; andU.S. Pat. No. 4,336,383, each of which is incorporated herein byreference.

In other embodiments, the CaMKK inhibitor is a biological molecule, suchas a polynucleotide having RNAi activity against a CaMKK or a substratethereof, or an antibody that can specifically bind to a CaMKK or asubstrate thereof.

Nucleic Acids/RNAi

Embodiments of the disclosure relate to methods that include CaMKKinhibitors, wherein the inhibitors comprise nucleic acid moleculeshaving inhibitory activity against one or more biological moleculesinvolved in a CaMK cascade including CaMK enzymes such as, for example,CaMKI and/or CaMKIV as well as kinases for such molecules (CaMKKα,CaMKKβ, etc.), other biological substrates of CaMKKs (e.g., AMPK), aswell as other CaMKs (e.g., CaMKII and CaMKIII). In embodiments, thenucleic acid molecules can include decoy RNAs, dsRNAs, siRNAs, nucleicacid aptamers, antisense nucleic acid molecules, and enzymatic nucleicacid molecules that comprise a sequence that is sufficient allow forbinding to a CaMK, AMPK, or CaMKK encoding nucleic acid sequence andinhibit activity thereof (i.e., are complementary to such encodingnucleic acid sequences).

In embodiments, the inhibitory nucleic acid molecule can bind to atarget CaMK, AMPK, or CaMKK nucleic acid sequence under stringentbinding conditions. The terms “stringent conditions” “stringent bindingconditions” or “stringent hybridization conditions” refers to conditionsunder which a polynucleotide will hybridize to a target sequence, to adetectably greater degree than other sequences (e.g., at least 2-foldover background). An example of stringent conditions include those inwhich hybridization in 50% formamide, 1 M NaCl, 1% SDS at 37° C., and awash in 0.1×SSC at 60° C. to 65° C. is performed. Amino acid andpolynucleotide identity, homology and/or similarity can be determinedusing the ClustalW algorithm, MEGALIGN™ (Lasergene, Wis.).

Given a target polynucleotide sequence of a CaMK, CaMKK, or biologicalsubstrate thereof, an inhibitory nucleic acid molecule can be designedusing motifs and targeted to a region that is anticipated to beeffective for inhibitory activity, such as is known in the art.

Antibodies

Embodiments of the disclosure relate to methods that include CaMKKinhibitors, wherein the inhibitors comprise antibodies having specificbinding activity against one or more biological molecules involved in aCaMK cascade including CaMK enzymes such as, for example, CaMKI and/orCaMKIV as well as kinases for such molecules (CaMKKα, CaMKKβ, etc.),biological substrates of CaMKKs (e.g., AMPK), and CaMKs that are notsubstrates of CaMKKs (e.g., CaMKII and CaMKIII).

Preparation of Antibodies

The antibodies described herein can be produced by any method known inthe art, such as by immunization with a full-length CaMK or CaMKK, orfragments thereof. The antibodies can be polyclonal or monoclonal,and/or may be recombinant antibodies. In embodiments, antibodies thatare human antibodies can be prepared, for example, by immunization oftransgenic animals capable of producing a human antibody (see, forexample, International Patent Application, Publication WO 93/12227).

Monoclonal antibodies (mAbs) can be produced by a variety of techniques,including conventional monoclonal antibody methodology, e.g., thestandard somatic cell hybridization technique of Kohler and Milstein[Nature (1975); 256:495], and other techniques, e.g., viral or oncogenictransformation of B-lymphocytes.

Animal systems for preparing hybridomas include mouse. Hybridomaproduction in the mouse is very well established, and immunizationprotocols and techniques for isolation of immunized splenocytes forfusion are well known in the art. Fusion partners (e.g., murine myelomacells) and fusion procedures are also known.

In embodiments, human monoclonal antibodies directed against a CaMK orCaMKK can be generated using transgenic mice carrying parts of the humanimmune system rather than the mouse system. These transgenic mice,referred to herein as “HuMab” mice, contain a human immunoglobulin geneminilocus that encodes unrearranged human heavy (μ and γ) and κ lightchain immunoglobulin sequences, together with targeted mutations thatinactivate the endogenous μ and κ chain loci [Lonberg et al., Nature(1994); 368:856-859]. The preparation of HuMab mice is described indetail in Taylor et al., Nucleic Acids Res. (1992); 20:6287-6295; Chenet al., International Immunology (1993); 5:647-656; Tuaillon et al., J.Immunol. (1994); 152:2912-2920; Lonberg et al., Nature (1994);368:856-859; Lonberg, Handbook of Exp. Pharmacology (1994); 113:49-101;Taylor et al., International Immunology (1994); 6:579-591; Lonberg &Huszar, Intern. Rev. Immunol. (1995); 13:65-93; Harding & Lonberg, AnnN.Y. Acad. Sci. (1995); 764:536-546; Fishwild et al., NatureBiotechnology (1996); 14:845-851, the contents of all of which arehereby incorporated by reference in their entirety. See further U.S.Pat. Nos. 5,545,806; 5,569,825; 5,625,126; 5,633,425; 5,789,650;5,877,397; 5,661,016; 5,814,318; 5,874,299; and 5,770,429; all toLonberg and Kay, as well as U.S. Pat. No. 5,545,807 to Surani et al.;International Patent Application Publication Nos. WO 93/1227, publishedJun. 24, 1993; WO 92/22646, published Dec. 23, 1992; and WO 92/03918,published Mar. 19, 1992, the disclosures of all of which are herebyincorporated by reference in their entirety.

Embodiments provide human monoclonal antibodies that are specific forand neutralize biological activity of human CaMK and/or CaMKKpolypeptides. Such antibodies can comprise heavy and light chain aminoacid sequences, the light and heavy chain variable regions, and anycombination (including all) hypervariable CDR regions, which arespecific for and neutralize CaMK and/or CaMKK polypeptides when theybind. Such antibodies can provide an effective immunotherapy for CaMKand CaMKK associated diseases including various cancers, such prostatecancer, glioma, glioblastoma, and myeloid leukemia. Such antibodies alsoprovide a useful reagent for the detection of a CaMK or a CaMKK in abiological sample.

In an embodiment, the antibodies target an epitope in a region of CaMKand/or CaMKK located in the C-terminal portion. In some embodiments, theantibody recognizes and binds specifically to an epitope in theC-terminal region of CaMKKβ splice variants 2 and/or 7.

In some embodiments, the antibodies are of the IgG1, IgG2, IgG3, or IgG4isotype. In other embodiments, the antibodies of the invention are ofthe IgM, IgA, IgE, or IgD isotype. In certain embodiments, theantibodies are cloned for expression in mammalian cells. In embodiments,the antibodies can be a fragment of an antibody that retains specificbinding activity for a CaMK or CaMKK polypeptide and is effective toinhibit biological activity. Such fragments are known in the art andinclude, for example, single-chain antibodies (scFV), Fab, Fab′, Fab₂,and the like.

Any of the CaMKK inhibitors disclosed herein and which are useful in themethods described herein can be provided as salts such as, for example,basic or acidic addition salts. The selection and formation of suchsalts are within the ability of one skilled in the art. See, e.g.,Remington: The Science and Practice of Pharmacy, 21^(st) ed., LippincottWilliams & Wilkins, A Wolters Kluwer Company, Philadelphia, Pa. (2005).

Further, embodiments of the disclosure provide for compositions orformulations comprising any of the CaMKK inhibitors disclosed hereinthat can are suitable for pharmaceutical use. Further, such formulationscan be provided in suitable dosage forms. Such compositions,formulations, and dosage forms are known to those of skill in the art.For example, compounds of Formulas I-III can be provided as acomposition or formulation and prepared in a dosage form as describedU.S. patent application publication number US 2010/0105716, which isincorporated by reference herein. See, also, Remington: The Science andPractice of Pharmacy, 21^(st) ed., Lippincott Williams & Wilkins, AWolters Kluwer Company, Philadelphia, Pa. (2005).

In an aspect, the disclosure provides a method for screening oridentifying a compound having agonist or antagonist activity for CaMKK(including CaMKKβ and/or CaMKKα) that includes contacting CaMKK and asubstrate therefor, in the presence and absence of a test compound,under conditions that allow for CaMKK-dependent phosphorylation of thesubstrate; and determining, directly or indirectly, the level ofphosphorylation of the substrate, wherein a reduction in phosphorylationof the substrate in the presence of the test compound is indicative of aCaMKK antagonist (for example, an anticancer agent) and an increase inphosphorylation of the substrate in the presence of the test compound isindicative of a CaMKK agonist. In embodiments, the CaMKK is CaMKKβ.

In some embodiments of this aspect, the method identifies a compoundthat is selective for a specific CaMK relative to at least one otherCaMK. In further embodiments, the method identifies a compound that isselective for CaMKKβ relative to at least one other CaMK such as, forexample, CaMKI, CaMKII, CaMKIII, CaMKIV, or CaMKKα. Yet furtherembodiments of the method provide identification of a compound that isselective for CaMKKβ splice variant 2 or CaMKKβ splice variant 7,relative to at least one other CaMKKβ isoform, and relative to at leastone other CaMK such as, for example, CaMKI, CaMKII, CaMKIII, CaMKIV, orCaMKKα.

Embodiments of these methods provide compounds having selectiveantagonist activity for a CaMK wherein the CaMK-dependentphosphorlyation of the substrate is reduced by about 4-fold or more inthe presence of the compound compared to phosphorylation in the absenceof the compound (e.g., about 4-fold to about 100-fold or more).

Merely for purposes of illustration of an embodiment of this aspect, anassay system can comprise calmodulin (CaM), calcium, CaMKKβ, and asubstrate (such as a synthetic peptide that can be phosphorylated byCaMKKβ such as from either AMPK or CaMKIV). The assay can furthercomprise evaluation of the test compound(s) that involves AMPK as theenzyme and a peptide from acetyl-CoA-carboxylase (ACC) as the substrate.In particular, assay conditions that allow for phosphorylation areprovided (e.g., any appropriate buffer system) and further includes oneor the other of CaMKKα and CaMKKβ (i.e., run in parallel), a calciumsalt (e.g., CaCl₂), a phosphate source (e.g., ATP, optionally comprisingradiolabelled ³²P), calmodulin (CaM, e.g., from bovine), and twosubstrates (one that can be phosphorylated by both CaMKKα and CaMKKβ,while the other can only be phosphorylated by one or the other of CaMKKαor CaMKKβ). A non-limiting example of a substrate that can bephosphorylated by both CaMKKα and CaMKKβ includes CaMIV, or a peptidefragment thereof (for example,Lys-Lys-Lys-Lys-Glu-His-Gln-Val-Leu-Met-Lys-Thr-Val-Cys-Gly-Thr-Pro-Gly-Tyr).A non-limiting example of a substrate that can be phosphorylated byCaMKKβ and not CaMKKα includes AMPK, or a peptide fragment thereof (forexample,Ala-Lys-Pro-Lys-Gly-Asn-Lys-Asp-Tyr-His-Leu-Gln-Thr-Cys-Cys-Gly-Ser-Leu-Ala-Tyr-Arg-Arg-Arg).Any substrate, including fragments thereof can be used in these methods,as long as the substrate can be phosphorylated. Differences between theamount of phosphorylation of the substrates can be used to evaluate thesubstrate specificity and selectivity of a candidate test compound.Concentrations of the various assay components can vary widely, but areusually in the range of 1 nM to 500 μM (for active reagents includingproteins and substrates, phosphate source(s) and test compounds) and inthe mM range for other assay components (calcium and magnesiumsalts/cofactors, reducing agents, buffer systems, etc.). Incubation timeand temperature can also be varied depending on the particular activityand sensitivity of the assay components. In embodiments, the temperaturecan range from about 4° C. to about 30° C., and the incubation time canbe on the order of minutes (e.g., 10 minutes) to hours (e.g., 1 hrs, 1.5hrs, 2 hrs, 2.5 hrs, 3 hrs, 3.5 hrs, etc.). In embodiments, a selectiveinhibitor will inhibit CaMKKβ activity to a greater extent than it willinhibit CaMKKαactivity. In some embodiments the selective inhibitor willinhibit CaMKKβ activity about anywhere from about 3-100 fold or more,relative to CaMKKαactivity (e.g., about 10-20 fold, about 20-30 fold,about 40-50 fold, about 50-60 fold, about 60-70 fold, about 70-80 fold,about 80-90 fold, about 90-100 fold, or over 100 fold).

Embodiments of the disclosure provide for detection of CaMKK, such asCaMKKβ and/or CaMKKα in circulating tumor cells (CTCs). CTCs are knownin the art and comprise cells that have detached from a primary tumorand circulate in the bloodstream. It is thought that CTCs may indicatepotential for metastasis and spread of a primary tumor to differenttissues. Thus, circulating tumor cells can be a factor indicating themetastatic spread of cancers, such as carcinomas, and can be used inmethods for the detection of, and prognosticate the likelihood of,metastatic disease. See, e.g., Fidler I. J., Nat Rev Cancer (2003);3:453-8; Sleijfer S., et al., Eur J Cancer (2007); 43:2645-50; Hayes D.F., and Smerage J., Clin Cancer Res (2008); 14:3646-50; Pantel K, etal., Nat Rev Clin Oncol (2009); 6:339-51; Pantel K., and Riethdorf S.,Nat Rev Clin Oncol. (2009); 6:190-1; and Panteleakou Z., et al., Mol Med(2009); 15:101-14, all incorporated by reference. Methods for expandingand enriching the number of CTCs in a biological sample are known in theart and allow for measurable amounts of a biochemical marker (a geneticor biochemical signature, such as CaMKKβ) of disease (e.g., anandrogen-driven cancer). Accordingly, methods for detecting the presenceof a CaMK, such as CaMKKβ/α or phosphorylated AMPK allow foridentification of therapies that can be useful in treatment of disease.In embodiments, such methods provide for a method of monitoring thecourse of a therapeutic treatment, such as administering an inhibitor ofCaMKKβ, in a patient undergoing therapy, based on a detectable increaseor decrease in the amount of the biochemical marker(s) in a samplecomprising CTCs. Such analytic methods include Kaplan Meier Analysiswhich has been used to correlate overall survival before starting a newline of therapy for patients with metastatic breast, colorectal andprostate cancer. Patients can be divided into those with Favorable andUnfavorable CTC (Unfavorable: >5 CTC/7.5 mL for breast and prostate, >3CTC/7.5 mL for colon). See, Miller, M. C., et al., J of Oncology. 2010.doi:10.1155/2010/617421. incorporated by reference. Methods known in theart, such as the CellSearch system (“Veridex CellSearch Website”. March2010. http://veridex.com/CellSearch/CellSearchHCP.aspx. Retrieved2010-03-14, as well as other methods, have been demonstrated as a strongprognostic factor for overall survival in patients with metastaticbreast, colorectal or prostate cancer. See, e.g., Paterlini-Brechot P,and Benali N. L., Cancer Lett. (2007); 253:180-204; “Veridex LLC.CellSearch circulating tumor cell kit premarket notification—expandedindications for use—metastatic prostate cancer”. March 2010.http://www.fda.gov/cdrh/pdf7/K073338.pdf. Retrieved 2010-03-14;Cristofanilli M., et al., NEJM (2004); 351:781-91; Budd G., et al., ClinCan Res (2006); 12:6404-09; Cohen, S. J., et al., JCO (2008);26:3213-21; DeBono, J. S., et al., Clin Can Res (2008); 14:6302-9;Allard, W. J., et al., Clin Can Res (2004); 10:6897-6904; and Riethdorfet al., Clin Cancer Res (2007); 13:920-8, all incorporated by reference.

In an aspect, the disclosure also provides a method for treatingconditions or diseases associated with abnormal AMP-activated proteinkinase (AMPK) activity, which includes increased phosphorylation ofAMPK, by administering an effective amount of at least one compound thatinhibits CaMKKβ to a subject having such a condition or disease.Diseases characterized by abnormal AMPK activity include, but are notlimited to, various cancers including prostate cancer.

As used herein, the term “subject” is intended to include human andnon-human animals. Exemplary human subjects include a human patienthaving a disorder, e.g., a disorder described herein, such as cancer, ora normal subject. The term “non-human animals” includes all vertebrates,e.g., non-mammals (such as chickens, amphibians, reptiles) and mammals,such as non-human primates, domesticated and/or agriculturally usefulanimals (such as sheep, dogs, cats, cows, pigs, etc.), and rodents (suchas mice, rats, hamsters, guinea pigs, etc.).

“Treatment” or “treat” refers to both therapeutic treatment andprophylactic or preventative measures. Those subjects in need oftreatment include those already with the disorder as well as those proneto have the disorder or those in which the disorder is to be prevented.

The terms “treating” and “treatment” refer to both therapeutic treatmentand prophylactic or preventative measures. Those subjects in need oftreatment include those already with the disorder as well as those proneto have the disorder or those in which the disorder is to be prevented.When used with reference to a disease or a subject in need of treatmentthe terms accordingly include, but are not limited to, halting orslowing of disease progression, remission of disease, prophylaxis ofsymptoms, reduction in disease and/or symptom severity, or reduction indisease length as compared to an untreated subject. In embodiments, themethods of treatment can abate one or more clinical indications of theparticular disease being treated. Certain embodiments relating tomethods of treating a disease or condition associated with activation ofa substrate in a CaMK cascade (CaMKI, CaMKIV, AMPK) and compriseadministration of therapeutically effective amounts of a compound thatinhibits CaMKKβ, as well as pharmaceutical compositions thereof. Inembodiments, the method of treating can relate to any method thatprevents further progression of the disease and/or symptoms, slows orreduces the further progression of the disease and/or symptoms, orreverses the disease and/or clinical symptoms associated with expressionof CaMKKβ or kinase activity thereof.

In embodiments, the methods are used to treat cancer in a subject,wherein the subject is a mammal. Yet further embodiments relate tomethods wherein the mammal is a human.

Aspects of the disclosure provide a method of inhibiting CaMKKβ in acell, including a cell within a subject, comprising contacting the cellwith a compound in an amount effective to inhibit CaMKKβ activity. Inembodiments, the method provides for inhibiting CaMKKβ activity in acell in a subject, wherein the method includes administering to thesubject a compound, or a pharmaceutically acceptable salt thereof,according to Formula I in an amount effective to inhibit CaMKKβ activityin the cell in the subject. Both the activity of CaMKKβ and AMPK can bemonitored by any method familiar to those of skill in the art. In someembodiments CaMKKβ and/or AMPK activity can be monitored by clinicalevaluation of the symptoms or stage of a disease associated withabnormal CaMKKβ and/or AMPK activity. In embodiments, the disease iscancer. In further embodiments, the cancer is glioma, glioblastoma,carcinoma, or leukemia. In some embodiments, the cancer is prostatecancer, cancer of the blood or bone marrow, or cancer of the brain/CNS.

In these embodiments, “inhibiting” or “inhibition” of CaMKKβ means thatthere is a measurable decrease in the activity of CaMKKβ in the presenceof a compound (e.g., through contacting/administration), relative to theactivity of CaMKKβ in the absence of the compound. As described above,the decrease in CaMKKβ activity can arise from direct inhibition ofkinase activity by, for example, binding of a small molecule inhibitorof Formulas I-III to the active site of CaMKKβ. A decrease in CaMKKβactivity can also arise from inhibition of expression of a CaMKKβ genevia antisense inhibition, gene silencing, disruption or degradation ofCaMKKβ mRNA via RNAi (e.g., siRNA). CaMKKβ expression can also bemodulated indirectly by manipulating the activity or expression of aregulator of CaMKKβ, such as androgen receptor (AR) or proteins involvedin CaMKKβ splicing activity such as Fox2/RTA-1, using any agent havingsuch activity. In embodiments, CaMKKβ can be inhibited by about 10% toabout 100% or more (e.g., about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%,90%, 100%, 200%, 300%, 500%, etc.) relative to a control. In someembodiments compounds can inhibit CaMKKβ (e.g., IC₅₀) at concentrationsfrom about 0.1 nM to about 500 μM, (e.g., about 0.1 nM to about 250 μM,about 0.5 nM to about 200 μM, about 1.0 nM to about 100 μM, about 10 nMto about 50 μM, or about 100 nM to about 10 μM, and the like).

In some embodiments the therapeutically effective amount is an amountsufficient to stop or slow the progression of the cancer. In furtherembodiments, the therapeutically effective amount is an amountsufficient to reduce the number of cancer cells in the subject (i.e.,killing of cancer cells). Methods for monitoring the proliferation ofcancer cells and progress of cancer in a subject (e.g., tumor size, cellcounts, biochemical markers, secondary indications, etc.) are known inthe art.

In various embodiments of the method, the cancer is associated with theactivity of CaMKKβ. Non-limiting examples of cancer that are associatedwith CaMKKβ activity include carcinoma, melanoma, leukemia, myeloidleukemia, glioma, and glioblastoma. In embodiments, the cancer isleukemia, cancer of the prostate or cancer of the brain/central nervoussystem. In further embodiments, the cancer is prostate cancer.

In some embodiments, the method of treatment is used as a co-therapysuch as, for example, administration in conjunction with radiation,surgery, or other chemotherapeutics. In some embodiments, the methodincludes administration of a therapeutically effective amount of acompound that inhibits CaMKKβ in combination with an additionalanti-cancer agent. A wide variety of anti-cancer (i.e., anti-neoplastic)agents are known in the art and include, for example alkylating agents,antimetabolites, natural antineoplastic agents, hormonal antineoplasticagents, angiogenesis inhibitors, differentiating reagents, RNAinhibitors, antibodies or immunotherapeutic agents, gene therapy agents,small molecule enzymatic inhibitors, biological response modifiers, andanti-metastatic agents.

In embodiments, the method comprises treating prostate cancer in asubject who is in need of treatment, where the method includesadministering to the subject an effective amount of a CaMKK inhibitor incombination with a second treatment. In such embodiments, the secondtreatment can include such non-limiting examples as surgery, radiation,and chemotherapy. In further embodiments, the method comprisesco-administration of an effective amount of a CaMKK inhibitor and asecond agent effective against prostate cancer such as, for example,anti-androgens, Selective Androgen Receptor Modulators (SARMs),Selective Androgen Receptor Degraders (SARDs), CYP17 inhibitors,suphatase inhibitors, Src inhibitors, anti-estrogens, estrogens,Selective Estrogen Receptor Modulators (SERMs), Selective EstrogenReceptor Degraders (SERDs), ERb antagonists, aromatase inhibitors,vaccine-based therapeutics such as sipuleucel-T)(Provenge®, and thelike. In further embodiments the method comprises administration aneffective amount of a CaMKK inhibitor and an active agent selected fromMDV3100 (an androgen receptor antagonist from Medivation Inc., SanFrancisco, Calif.); ARN-509 (an androgen receptor antagonist from AragonPharmaceuticals, San Diego, Calif.); bicalutamide (Casodex® anon-steroidal anti-androgen from AstraZeneca); or flutamide (Eulexin® anon-steroidal anti-androgen from Schering-Plough).

In some embodiments, the method of treatment can be used an adjuvanttherapy (i.e., additional treatment) such as, for example, whencompounds of any of Formulas I-III, or pharmaceutical compositionsthereof, are administered after surgery or other treatments (e.g.,radiation, hormone therapy, or chemotherapy). Accordingly, in suchembodiments, the method of adjuvant therapy encompasses administeringthe compounds of Formula I-III to a subject following a primary orinitial treatment, and can be administered either alone or incombination with one or more other adjuvant treatments, including, forexample surgery, radiation therapy, or systemic therapy (e.g.,chemotherapy, immunotherapy, hormone therapy, or biological responsemodifiers). Those of skill in the art will be able to use statisticalevidence to assess the risk of disease relapse before deciding on thespecific adjuvant therapy. The aim of adjuvant treatment is to improvedisease-specific and overall survival. Because the treatment isessentially for a risk, rather than for provable disease, it is acceptedthat a proportion of patients who receive adjuvant therapy will alreadyhave been effectively treated or cured by their primary surgery.Adjuvant therapy is often given following surgery for many types ofcancer including, for example, colon cancer, lung cancer, pancreaticcancer, breast cancer, prostate cancer, and some gynecological cancers.

Some embodiments of the method relate to neoadjuvant therapy, which isadministered prior to a primary treatment. Effective neoadjuvant therapyis commonly characterized by a reduction in the number of cancer cells(e.g., size of the tumor) so as to facilitate more effective primarytreatment such as, for example, surgery.

The term “cancer” refers to or describes the physiological condition inmammals that is typically characterized by unregulated cell growth. Somenon-limiting examples of cancer include carcinoma, melanoma, lymphoma,blastoma, sarcoma, germ cell tumors, and leukemia or lymphoidmalignancies. Non-limiting examples of cancers that fall within thesebroad categories include squamous cell cancer (e.g., epithelial squamouscell cancer), lung cancer including small-cell lung cancer, non-smallcell lung cancer, adenocarcinoma of the lung and squamous carcinoma ofthe lung, cancer of the peritoneum, hepatocellular cancer, gastric orstomach cancer including gastrointestinal cancer, pancreatic cancer,glioblastoma, cervical cancer, ovarian cancer, liver cancer, bladdercancer, cancer of the urinary tract, hepatoma, breast cancer, coloncancer, rectal cancer, colorectal cancer, endometrial or uterinecarcinoma, salivary gland carcinoma, kidney or renal cancer, prostatecancer, vulval cancer, thyroid cancer, hepatic carcinoma, analcarcinoma, melanoma, multiple myeloma and B-cell lymphoma, brain, aswell as head and neck cancer, and associated metastases.

The term “cancer” also encompasses cell proliferative disorders whichare associated with some degree of abnormal cell proliferation, andincludes tumors. “Tumor” as used herein, refers to any neoplasm orneoplastic cell growth and proliferation, whether malignant or benign,and all pre-cancerous and cancerous cells and tissues. In embodimentsdisclosed above, the cancer can be prostate cancer, cancer of thebrain/CNS (glioma, glioblastoma, etc.), or leukemia (myeloid leukemia).

Administration of an effective amount of an inhibitor of CaMKK such as,for example a compound of Formula I-III, such as STO-609 for example, toa subject may be carried out by any means known in the art including,but not limited to intraperitoneal, intravenous, intramuscular,subcutaneous, or transcutaneous injection or oral, nasopharyngeal ortransmucosal absorption. Such administration encompasses theadministration of a CaMKK inhibitor formulated as a pharmaceuticalcomposition. Delivery (administration route) also includes targeteddelivery wherein the CaMKK inhibitor is only active in a targeted regionof the body (for example, in the prostate and/or cancerous tissues), aswell as sustained release formulations in which the CaMKK inhibitorcompound is released over a period of time in a controlled manner.Sustained release formulations and methods for targeted delivery areknown in the art and include, for example, use of liposomes, drug loadedbiodegradable microspheres, drug-polymer conjugates, drug-specificbinding agent conjugates and the like. Pharmaceutically acceptablecarriers are well known to those of skill in the art. Determination ofparticular pharmaceutical formulations and therapeutically effectiveamounts and dosing regimen for a given treatment is within the abilityof one of skill in the art taking into consideration, for example,patient age, weight, sex, ethnicity, organ (e.g., liver and kidney)function, the extent of desired treatment, the stage and severity of thedisease and associated symptoms, and the tolerance of the patient forthe treatment.

Kits

In an aspect, the disclosure relates to kits. Such kits can be used inmethods of identifying a cancer that can be responsive to a method oftreatment comprising administration of a CaMKK inhibitor, methods ofidentifying a compound as an inhibitor of CaMKK, methods of evaluatingefficacy of a therapeutic regimen comprising administration of a CaMKKinhibitor, and the like. Kits can also include appropriate buffersystems and reagents, such as substrates of one or more CaMKKs,phosphate-donating groups (optionally radiolabelled phosphate-donatinggroups such as ³²P-ATP), a calmodulin and a calcium source, typically acalcium salt, and molecules that can detect the presence of a CaMK orCaMKK (e.g., antibodies). Kits also include instructions for use.

It will be understood that any numerical value recited herein includesall values from the lower value to the upper value. For example, if aconcentration range is stated as 1% to 50%, it is intended that valuessuch as 2% to 40%, 10% to 30%, or 1% to 3%, etc., are expresslyenumerated in this specification. These are only examples of what isspecifically intended, and all possible combinations of numerical valuesbetween the lowest value and the highest value enumerated are to beconsidered to be expressly stated in this application.

Also, it is to be understood that the phraseology and terminology usedherein is for the purpose of description and should not be regarded aslimiting. The use herein of terms such as “comprising,” “including,”“having,” and variations thereof is meant to encompass the items listedthereafter and equivalents thereof as well as additional items.“Comprising” encompasses the terms “consisting of” and “consistingessentially of.” The use of “consisting essentially of” means that thecomposition or method may include additional ingredients and/or steps,but only if the additional ingredients and/or steps do not materiallyalter the basic and novel characteristics of the claimed composition ormethod.

All patents publications and references cited herein are hereby fullyincorporated by reference.

While the following examples provide further detailed description ofcertain embodiments of the invention, they should be considered merelyillustrative and not in any way limiting the invention, as defined bythe claims.

EXAMPLES

Materials and Methods.

Cell Culture and RNA.

The LNCaP and VCaP human prostate carcinoma cell lines were obtainedfrom ATCC and maintained as recommended. All experiments were performedwith cells of passage less than 25. These cells were authenticated bymorphological inspection and mycoplasma testing by the ATCC.Furthermore, their response to androgens was authenticated using growthand reporter gene assays. RNA from placenta, skeletal muscle,cerebellum, whole brain and normal prostate was from Clontech (MountainView, Calif.). RNA from glioblastoma cell lines was a generous gift fromValerie Curtis (Duke University, Durham, N.C.).

RNA Isolation, cDNA Preparation, and Quantitative and Standard ReverseTranscription (RT)-PCR.

RNA isolation, cDNA preparation and quantitative RT-PCR (qPCR) wereperformed as previously described using 36B4 as a control (12). StandardRT-PCR was performed using the Advantage GC 2 Polymerase Mix and PCR Kit(Clontech). All qPCR and RT-PCR primers used in this study are listed inTable 1.

Western Blot Analysis.

Western blots were performed as previously described (12) with theexception that a modified radioimmunoprecipitation assay (RIPA) buffer[50 mM Tris (pH 8.0), 200 mM NaCl, 1.5 mM MgCl₂, 1% Triton X-100, 1 mMEGTA, 10% glycerol, 50 mM NaF, 2 mM Na₃VO₄ and protease inhibitors] wasused. Results shown are representative blots. For each sample, proteinlevels were determined by densitometry using the ImageJ software (NIH)and normalizing to indicated controls.

Small Interfering RNA (siRNA) Transfection of Human Prostate Cells.

Stealth siRNA (Invitrogen) transfections were performed as previouslydescribed (5). The sequences of all siRNAs used in this study are listedin Table 1.

Chromatin Immunoprecipitation (ChIP).

ChIP was performed as previously described (4). All primers used forChIP qPCR analysis are listed in Table 1.

Transient Transfections and Reporter Gene Assays.

Transient transfections and reporter gene assays were performed aspreviously described (4).

Cell Proliferation Assay.

Proliferation assays were performed as previously described (12) bymeasuring the cellular DNA content using the FluoReporter BlueFluorometric double-stranded DNA Quantitation Kit (Invitrogen) as perthe manufacturer's protocol.

Migration and Invasion Assays.

Boyden dual chamber migration assays were performed as previouslydescribed (4). Invasion assays were performed the same as migrationassays except that inserts were layered with 100 ml of Matrigelextracellular matrix (BD Biosciences) prior to reseeding of cells.

Statistical Analysis.

Data were analyzed using one-way ANOVA and post hoc Dunnett's test withGraphPad Prism, Version 4 (GraphPad Software, Inc.). Unless otherwisenoted, significance was determined at the P<0.05 level.

Chemicals.

Methyltrienolone (R1881) was purchased from PerkinElmer (Waltham, Mass.)and dissolved in ethanol. Bicalutamide (Casodex) was provided as a giftfrom P. Turnbull (GlaxoSmithKline, Research Triangle Park, N.C.) andresuspended in a 1:1 mixture of ethanol and dimethylsulfoxide (DMSO).Cycloheximide was obtained from Sigma (St Louis, Mo.) and dissolved inDMSO. Compound C (in DMSO) was from Calbiochem (San Diego, Calif.).STO-609 was purchased from Tocris (Ellisville, Mo.) and resuspended in100 mM NaOH. 5-aminoimidazole-4-carboxamide 1-b-D-ribo-furanoside(AICAR) was from Enzo Life Sciences (Plymouth Meeting, Pa.) anddissolved in water.

Antibodies.

The CaMKK antibody used, unless otherwise specified, was from BDBiosciences (Palo Alto, Calif.). The CaMKKβ (clone 1A11) antibody wasfrom Abnova (Walnut, Calif.). The v5 antibody was purchased fromInvitrogen (Carlsbad, Calif.). The GAPDH and AR antibodies havepreviously been described (1). Phospho-CaMKI (T177), CaMKI and Lamin Aantibodies were from Santa Cruz Biotechnology, Inc. (Santa Cruz,Calif.). Phospho-AMPKα(T172), AMPKα, phospho-acetyl-CoA carboxylase(S79), and acetyl-CoA carboxylase antibodies were from Cell SignalingTechnology (Danvers, Mass.).

Plasmids.

The CMV-βgal and PSA-Luc plasmids were previously described (2). ThepGL4.14 (lacks both basal promoter and enhancers) and pGL4.26 (lacksenhancer, but contains basal promoter) vectors were obtained fromPromega (Madison, Wis.). MSCV-GWb-GAL4(DNA-binding domain(DBD))-IRES-EGFP, MSCV-GWb-CaMKKβ—IRES-EGFP, MSCV-GWb-v5-ARwt-IRES-EGFPand MSCV-GWb-v5-AR(C562S)—IRES-EGFP were created using the InvitrogenGateway recombinase subcloning system according to the manufacturer'sinstructions. To do this, GAL4(DBD), CaMKKβ, v5-ARwt or v5-AR(C562S)were shuttled from pENTR-GAL4(DBD), pENTR-v5-ARwt, pENTR-v5-AR(C562) orpOTB7-CaMKKβ_prostate splice variant (American Type Culture Collection(ATCC), Manassas, Va.) to MSCV-IRES-EGFP that was converted to a Gatewaydestination vector. The pGL4.14-CaMKKβ promoter construct was created byPCR amplifying a 2.1 kb genomic sequence that encompassed the CaMKKβtranscriptional start site through the potential AR binding siteidentified using ChIP on Chip (previously described (3)). This fragmentwas then cloned into the pGL4.14 vector using NheI and HindIIIrestriction sites. Subsequent deletion constructs were created by PCRamplifying smaller fragments that were cloned into pGL4.26 using NheIand HindIII restriction sites. Finally, the pGL4.14-CaMKKβ promoter-AREdeletion construct was created from the original pGL4.14-CaMKKβ promoterconstruct using the ExSite PCR-Based Site-Directed Mutagenesis Kit(Stratagene, La Jolla, Calif.). All primers used for the creation ofconstructs are listed in Supplementary Table 1. All sequences wereconfirmed using restriction digests and sequencing.

Creation of Stable Cell Lines.

To create LNCaP-GAL4, LNCaP-CAMKK

LNCaP-v5-ARwt and LNCaP-v5-AR(C562S) cells, parental cells were infectedwith retrovirus expressing MSCV-GWb-GAL4(DBD)-IRES-EGFP (negativecontrol), MSCV-GWb-CAMKKβ-IRES-EGFP, MSCV-GWb-v5-ARwt-IRES-EGFP orMSCV-GWb-v5-AR(C562S)-IRES-EGFP. EGFP positive cells were then selectedthrough two rounds of cells sorting using flow cytometry and expressionlevels were confirmed by western blot and/or qPCR.

TABLE 1 Primers and siRNA sequences used in these studies Primer/siRNASequence (SEQ ID NO) qPCR primers 36B4Forward: 5′-GGACATGTTGCTGGCCAATAA-3′ (SEQ ID NO: 48)Reverse: 5′-GGGCCCGAGACCAGTGTT-3′ (SEQ ID NO: 49) CaMKKβForward: 5′-TCCAGACCAGCCCGACATAG-3′ (SEQ ID NO: 50)Reverse: 5′-CAGGGGTGCAGCTTGATTTC-3′ (SEQ ID NO: 51) CXCR4Forward: 5′-TGGCCTTATCCTGCCTGGTAT-3′ (SEQ ID NO: 52)Reverse: 5′-AGGAGTCGATGCTGATCCCAA-3′ (SEQ ID NO: 53) AR 3′UTRForward: 5′-CCATGGCACCTTCAGACTTT-3′ (SEQ ID NO: 54)Reverse: 5′-ACTGGGCCATATGAGGATCA-3′ (SEQ ID NO: 55) AMPKα1Forward: 5′-CTCAGTTCCTGGAGAAAGATGG-3′ (SEQ ID NO: 56)Reverse: 5′-CCCAGTCAATTCATGTTTGCC-3′ (SEQ ID NO: 57) AMPKα2Forward: 5′-ATGGAATATGTGTCTGGAGGTG-3′ (SEQ ID NO: 58)Reverse: 5′-TGGTTTCAGGTCTCGATGAAC-3′ (SEQ ID NO: 59) CaMKKβenhancer ChIP primers distal upstream controlForward: 5′-GCACAGTTTGCACACCTGAA-3′ (SEQ ID NO: 60)Reverse: 5′-GCTTTGGATTTAGGCCCTGT-3′ (SEQ ID NO: 61) CaMKKβ enhancerForward: 5′-AACAGGAAAGGACACCCAAA-3′ (SEQ ID NO: 62)Reverse: 5′-AAACCATTCTTAGCAGGCCAT-3′ (SEQ ID NO: 63) CaMKKβenhancer and promoter reporter gene primers promoterFwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′ (SEQ ID NO: 64)Rv: 5′-CAAAGCTTTGAGACAGGGTCTCTCTGTGTTGC-3′ (SEQ ID NO: 65)fragment A enhancer Fwd: 5′-CGCTAGCGAATTGCAACTGTGAGACCAGGCA-3′(SEQ ID NO: 66) Rv: 5′-CAAAGCTTGTGGCCTTGGGCAAATGACTTGAT-3′(SEQ ID NO: 67) fragment B enhancerFwd: 5′-CGCTAGCATCAAGTCATTTGCCCAAGGCCAC-3′ (SEQ ID NO: 68)Rv: 5′-CAAAGCTTAACACTGTAGCTCACACAGGCAGA-3′ (SEQ ID NO: 69)fragment C enhancer Fwd: 5′-CGCTAGCATCAAGTCATTTGCCCAAGGCCAC-3′(SEQ ID NO: 70) Rv: 5′-CAAAGCTTTATTTGATGCTCAGCCACCTCCCT-3′(SEQ ID NO: 71) fragment D/598 bp enhancerFwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′ (SEQ ID NO: 72)Rv: 5′-CAAAGCTTAAATGTGAAAGGCCAGGTGTGGTG-3′ (SEQ ID NO: 73)fragment E enhancer Fwd: 5′-CGCTAGCTGCCTGTGTGAGCTACAGTGTTCT-3′(SEQ ID NO: 74) Rv: 5′-CAAAGCTTAAATGTGAAAGGCCAGGTGTGGTG-3′(SEQ ID NO: 75) fragment F enhancerFwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′ (SEQ ID NO: 76)Rv: 5′-CAAAGCTTAACACTGTAGCTCACACAGGCAGA-3′ (SEQ ID NO: 77)fragment G enhancer Fwd: 5′-CGCTAGCCACCACACCTGGCCTTTCACATTT-3′(SEQ ID NO: 78) Rv: 5′-CAAAGCTTGCACTTTAAGGCAGGGTCAGCAAA-3′(SEQ ID NO: 79) fragment H enhancerFwd: 5′-CGCTAGCGTTTCAAGCGATTCTCCTGCCTCA-3′ (SEQ ID NO: 80)Rv: 5′-CAAAGCTTTCACGCCTGTAATCCCAGCACTTT-3′ (SEQ ID NO: 81)566 bp enhancer Fwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′(SEQ ID NO: 82) Rv: 5′-CAAAGCTTTACACGGGTGATTACAATCTTAGC-3′(SEQ ID NO: 83) 487 bp enhancerFwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′ (SEQ ID NO: 84)Rv: 5′-CAAAGCTTTGGACAACATGGCAAGACCCATCT-3′ (SEQ ID NO: 85)312 bp enhancer Fwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′(SEQ ID NO: 86) Rv: 5′-CAAAGCTTCTGGATCTCTTTTCCTGGTACTTG-3′(SEQ ID NO: 87) 233 bp enhancerFwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′ (SEQ ID NO: 88)Rv: 5′-CAAAGCTTACACTGTAGCTCACACAGGCAGAA-3′ (SEQ ID NO: 89)152 bp enhancer Fwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′(SEQ ID NO: 90) Rv: 5′-CAAAGCTTTACAAATCCAAACCCTAGCTCAAG-3′(SEQ ID NO: 91) 90 bp enhancerFwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′ (SEQ ID NO: 92)Rv: 5′-CAAAGCTTTGCTGTGAGCCAGGCCCTCCCTGC-3′ (SEQ ID NO: 93)69 bp enhancer Fwd: 5′-CGCTAGCAGGGAGGTGGCTGAGCATCAAATA-3′(SEQ ID NO: 94) Rv: 5′-CAAAGCTTCTGCCCGCTCCTCTCTCTGATGTC-3′(SEQ ID NO: 95) promoter-ARE deletionForward: 5′-CATACAGAATTGTTTAACAAGTACC-3′ (SEQ ID NO: 96)Rv: 5′-TAAATTGCCTGTGTTTTATTAGAACACTG-3′ (SEQ ID NO: 97) CaMKKβRT-PCR primers F(1-6) 5′-ACCTGTAATCCCAGCACTTTCGGA-3′ (SEQ ID NO: 98)R(1-6) 5′-CGATCTCGGATCACTGCAACCTCT-3′ (SEQ ID NO: 99) F(7)5′-TGAGCCGAGCCGAGCCGAGCTG-3′ (SEQ ID NO: 100) R(1-7)5′-TCACAGGGCTTCTGGCTTTCGCT-3′ (SEQ ID NO: 101) F15′-AGCTGAGGACTTGAAGGACCTGAT-3′ (SEQ ID NO: 102) R15′-AGGTTGTCTTCGCTGCCTTGCTT-3′ (SEQ ID NO: 103) R25′-ACCTGGGCTGGCTATGTGTATGAA-3′ (SEQ ID NO: 104) siRNA sequences CaMKKβ#1 5′-GGACCAUCUGUACAUGGUGUUCGAA-3′ (SEQ ID NO: 105) CaMKKβ #25′-GCUGACUUUGGUGUGAGCAAUGAAU-3′ (SEQ ID NO: 106) CaMKKβ #35′-CACCUGGGCAUGGAGUCCUUCAUUG-3′ (SEQ ID NO: 107) AR 3′UTR5′-CAGAUGUCUUCUGCCUGUUAUAACU-3′ (SEQ ID NO: 108) AMPKα1 #15′-CCCAUCCUGAAAGAGUACCAUUCUU-3′ (SEQ ID NO: 109) AMPKα1 #25′-CCCUCAAUAUUUAAAUCCUUCUGUG-3′ (SEQ ID NO: 110) AMPKα1 #35′-ACCAUGAUUGAUGAUGAAGCCUUAA-3′ (SEQ ID NO: 111) AMPKα2 #15′-GAUGGUGAAUUUCUGAGAACUAGUU-3′ (SEQ ID NO: 112) AMPKα2 #25′-CCGUAUGACAUUAUGGCUGAAGUUU-3′ (SEQ ID NO: 113) CaMKI #15′-GGAGATACAGCTCTAGATAAGAATA-3′ (SEQ ID NO: 114) CaMKI #25′-CCATAGGTGTCATCGCCTACATCTT-3′ (SEQ ID NO: 115)

Example 1 Androgens Increase CaMKKβ mRNA and Protein Levels in anAR-Dependent Manner

In an effort to identify novel prostate cancer therapeutics, we havefocused on defining key regulators downstream of AR action thatcontribute to prostate pathobiology and that may be amenable topharmacological exploitation. As a first step in this process, weanalyzed the expression level of mRNAs encoding targetable signalingmolecules using microarray data derived from androgen-treated LNCaPprostate cancer cells (13). These studies suggested that one suchcandidate, CaMKKβ, was upregulated by androgens. To confirm thesignificance of this observation, CaMKKβ mRNA levels were analyzed byqPCR following treatment with the synthetic androgen R1881. In bothLNCaP and VCaP prostate cancer cell lines, CaMKKβ mRNA levels increasedin a dose-dependent manner (FIG. 1A). Further, western immunoblotanalysis revealed a corresponding dose-dependent increase in CaMKKβprotein levels in both cell lines (FIG. 1B). The specificity of theantibodies used in this study was verified using three siRNAs targetingCaMKKβ mRNA (FIG. 1C). In addition, analogous immunoblot results wereobtained using a second antibody (clone 1A11) directed against CaMKKβ(FIG. 2). Finally, androgen-mediated induction, but not the basalexpression, of CaMKKβ mRNA was abrogated in cells in which AR expressionwas inhibited using a validated siRNA (4) directed against the AR mRNA(FIG. 1D). Taken together, these data demonstrate that androgens, actingthrough AR, increase both CaMKKβ mRNA and protein levels in multiplecellular models of prostate cancer.

Example 2 Functionally Active Splice Variants of CaMKKβ are Expressed inResponse to Androgens in the Prostate

Given that AR increases CaMKKβ levels in multiple cellular models ofprostate cancer, we next determined if its expression correlated withthe development of prostate cancer in human samples. Analysis of theclinically annotated prostate cancer data sets accessible throughOncomine revealed that CaMKKβ expression increases with grade (14-17)(FIG. 3A and FIG. 3B). Interestingly, this analysis also revealed thatCaMKKβ was consistently overexpressed in prostate tumors, but not othermalignancies (FIG. 3C) (18).

The full-length CaMKKβ protein is encoded by an mRNA composed of 18exons. Interestingly, the majority of commercially available CaMKKβantibodies target the C-terminus of the protein that is absent in somefunctionally active splice variants (19). Thus, given that theexpression of CaMKKβ in the prostate has not been reported previously,we hypothesized that the prostate, and prostate cancers, may express afunctionally important splice variant(s) of CaMKKβ that was notrecognized by the most commonly used antibodies. To test thishypothesis, we performed RT-PCR analysis using primers spanning variousexon boundaries to examine the splice variant repertoire in the normalprostate and in prostate cancer cells. In this manner, it wasdemonstrated that unlike in brain, which expresses a longer variant,both normal prostate and prostate cancer cells predominantly expressshorter variants of CaMKKβ (FIG. 4A, FIG. 4B, and FIG. 5). The variantsfound are equivalent to the previously described CaMKKβ splice variants2 and 7 that lack exon 16 (of note, splice variants 2 and 7 makeidentical protein products) (19). Interestingly, these shorter variantswere also found in brain tumors (FIG. 4B). A complete analysis of theadditional variants expressed in the prostate/prostate cancer isdescribed in FIG. 5. Phosphorylation of the classical CaMKKβ targetCaMKI was observed in both androgen-treated LNCaP and VCaP cells (FIG.4C), indicating that the CaMKKβ variant expressed in prostate cancercells is functionally active.

Example 3 CaMKKβ is Necessary and Sufficient for AR-Mediated ProstateCancer Cell Migration and Invasion

Given that the expression of CaMKKβ is upregulated by androgens and iselevated in prostate cancer, we next wanted to assess its potentialrole(s) in processes of pathological importance in this disease. As afirst step, we evaluated the ability of the CaMKK antagonist STO-609 toinhibit the androgen-mediated cellular growth of prostate cancer cells.However, at a concentration that suppressed CaMKKβ activity (FIG. 6A),this drug had no significant effect on LNCaP and VCaP cell number overthe seven-day period of this assay (FIG. 7A and FIG. 6B).

In addition to proliferation, androgens increase the migration ofprostate cancer cells (4, 20). Since CaMKKβ has recently been implicatedin cell migration during neuronal development (21, 22), we next askedwhether CaMKKβ is involved with AR-meditated prostate cancer cellmigration and/or invasion. Using Boyden dual chamber migration assays,treatment with the CaMKK antagonist STO-609 blocked theandrogen-mediated migration of both LNCaP (FIG. 7B, top) and VCaPprostate cancer cells (FIG. 6C). STO-609 also inhibitedandrogen-mediated invasion of LNCaP cells through a Matrigelextracellular matrix (FIG. 7B, bottom). Furthermore, knockdown of CaMKKβsuppressed, while its overexpression increased, both basal andandrogen-stimulated cell migration (FIG. 7C, FIG. 7D, FIG. 6D, and FIG.6E). These findings highlight a heretofore-unrecognized role for CaMKKβin prostate cancer cell migration and invasion.

Example 4 Definition of the Molecular Mechanism for AR-Mediated CaMKKβmRNA Expression

Using a knockdown/replacement strategy, it was demonstrated thatexpression of wild-type AR, but not a transcriptionally inactive DNAbinding mutant (C562S), was able to complement the knockdown ofendogenously expressed AR in an LNCaP cell migration assay (FIG. 8).Further, at a concentration that inhibits the expression of secondaryandrogen target genes (ex. CXCR4 (4)), cycloheximide treatment did notblock the R1881-mediated increase in CaMKKβ mRNA levels (FIG. 9A).Together, these data indicate that CaMKKβ is a primary AR target gene.

By mining our previously published ChIP on Chip data (23), we identifieda putative AR binding region located ˜2.3 kb upstream of the CaMKKβtranscriptional start site (FIG. 9B, top). No other AR binding wasdetected within the CaMKKβ gene or within 100 kb in either direction ofthe gene. The validity of this AR-binding site was confirmed using ChIPassays, which showed that AR was recruited to this region of thepromoter within one hour following R1881 treatment (FIG. 9B, bottom).Given these data, we focused on characterizing the functionality of theputative ARE identified. To this end, we cloned overlapping regions ofCaMKKβ's 5′ upstream region and tested their ability to confer androgenresponsiveness to an enhancerless luciferase reporter gene. In thismanner, we determined that a construct incorporating a fragment, −2231to −1632 (D), and an overlapping fragment, −2019 to −1632 (E), containedan AR-dependent enhancer (FIG. 9C). Both fragments D and E demonstratedandrogen responsiveness in a dose-dependent manner that was suppressedby the antiandrogen Casodex (FIG. 10A). Similar results were obtained inVCaP cells (FIG. 10B). Deletion analysis further narrowed down theandrogen-responsive region to a 79 by stretch of DNA that included asequence, GTAACAtgaTGTAAA, that resembled the consensus androgenresponse element (ARE) AGAACAnnnTGTTCT (FIG. 10C). Deletion of the 15 byARE in the full-length CaMKKβ promoter construct (−2231 to +83)completely abolished the androgen responsiveness (FIG. 9D). Thus, in thecontext of prostate cancer cells, CaMKKβ is a direct target of AR.

Example 5 Androgens Promote Prostate Cancer Cell Migration Through anAR-CaMKKβ-AMPK Signaling Axis

CaMKI, CaMKIV and, more recently, AMPK have been shown to be downstreamtargets of CaMKKβ (24). Since CaMKIV is not expressed in the prostate(data not shown), we tested whether AR-CaMKKβ signaling led to increasedCaMKI and/or AMPK signaling. Western blot analysis revealed thatandrogens increased the phosphorylation of both CaMKI and AMPK at theirCaMKKβ activation loop target sites (T177 and T172 respectively) in bothLNCaP and VCaP cells, an effect that was reversed by pretreatment withSTO-609 (FIG. 11A and FIG. 12A). Interestingly, we found thatoverexpression of CaMKKβ alone was sufficient to increase thephosphorylation/activity of AMPK, but not CaMKI (FIG. 11B). Thesefindings indicated that AMPK, rather than CaMKI, could be regulatingcell migration because CaMKKβ overexpression alone was also sufficientto increase migration (FIG. 7D). To verify this, we used our mostefficacious siRNAs (FIG. 12B) to knockdown both isoforms of thecatalytic subunit of AMPK (FIG. 11C, bottom and FIG. 12C) or CaMKI (FIG.11D, bottom and FIG. 12D). In this manner, it was demonstrated that lossof AMPK, but not CaMKI, resulted in decreased prostate cancer cellmigration (FIG. 11C and FIG. 11D). In support of these findings,cotreatment of cells with the AMPK antagonist compound C, at aconcentration that inhibited its kinase activity, completely abolishedandrogen-mediated cell migration (FIG. 13A and FIG. 13B). Conversely,treatment of LNCaP cells with the AMP mimetic AICAR alone was sufficientto increase cell migration (FIG. 13A and FIG. 13C). These data highlighta central role for AMPK in prostate cancer cell migration. Definition ofthe mechanism(s) by which AMPK interfaces with the cellular processesresponsible for migration and invasion is currently under investigation.

REFERENCES

The following references are incorporated herein by reference in theirentireties.

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1. A method of diagnosing prostate cancer in a subject comprising: a)obtaining a sample from the subject; b) determining an amount of atleast one of CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splice variant 7,phosphorylated AMPK, phosphorylated AMPKα1 subunit, and phosphorylatedAMPKα2 subunit in the sample from the subject; and c) comparing theamount of at least one of CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splicevariant 7, phosphorylated AMPK, phosphorylated AMPKα1 subunit, andphosphorylated AMPKα2 subunit from the sample from the subject to anamount of the CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splice variant 7,phosphorylated AMPK, phosphorylated AMPKα1 subunit, and phosphorylatedAMPKα2 subunit in a control sample; wherein the subject is diagnosed ashaving prostate cancer when the amount of at least one of CaMKKβ, CaMKKβsplice variant 2, CaMKKβ splice variant 7, phosphorylated AMPK,phosphorylated AMPKα1 subunit, and phosphorylated AMPKα2 subunit in thesample from the subject is greater than the amount in the controlsample.
 2. The method of claim 1, wherein the determining comprisesdetecting the amount of mRNA expression.
 3. The method of claim 1,wherein the determining comprises detecting the amount of at least oneprotein of CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splice variant 7,phosphorylated AMPK, phosphorylated AMPKα1 subunit, and phosphorylatedAMPKα2 subunit in the samples.
 4. The method of claim 1, wherein thesample from the subject comprises prostate tissue.
 5. The method ofclaim 3, wherein the detecting comprises an antibody that specificallybinds to a C-terminal portion of the amino acid sequence encoded byCaMKKβ, CaMKKβ splice variant 2, or CaMKKβ splice variant
 7. 6-16.(canceled)
 17. A method of screening a test compound for its anti-canceractivity comprising: i) contacting CaMKKβ and a substrate therefor inthe presence of the test compound, under conditions that allow forCaMKKβ-dependent phosphorylation of the substrate, and ii) determiningthe level of phosphorylation of the substrate resulting from step (i)and comparing the level with a level of phosphorylation of the substrateobtained in the absence of the test compound, wherein a reduction in thelevel of phosphorylation of the substrate in the presence of the testcompound indicates that the test compound has said anti-cancer activity.18. The method according to claim 17 wherein said substrate is a peptidesubstrate.
 19. The method according to claim 17 wherein the CaMKKβ andthe substrate are present in a cell free system.
 20. The methodaccording to claim 17 wherein the CaMKKβ and the substrate are presentin a cell.
 21. The method according to claim 17 wherein, in step (i),the CaMKKβ and the substrate are contacted with the test compound in thepresence of calmodulin and calcium under conditions such thatCaMKKβ-dependent phosphorylation of the substrate can be effected.22-26. (canceled)
 27. A method of treating prostate cancer in a subject,comprising administering to the subject an effective amount of acompound that inhibits activity of at least one of CaMKKβ, CaMKKβ splicevariant 2, or CaMKKβ splice variant
 7. 28. The method of claim 27,wherein the compound is selected from an inhibitory RNA or an antibodythat specifically binds to a C-terminal portion of CaMKKβ, CaMKKβ splicevariant 2, or CaMKKβ splice variant
 7. 29. The method of claim 27,wherein the compound has Formula III:

wherein R₁, R₂, R₃, R₄, R₅, R₆, R₇, R_(7a), R₈, R₉, R₁₀, and R₁₁ areeach independently selected from the group consisting of H, alkyl,alkenyl, alkynyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkenyl,cycloalkylalkynyl, heterocyclo, heterocycloalkyl, heterocycloalkenyl,heterocycloalkynyl, aryl, arylalkyl, arylalkenyl, arylalkynyl,heteroaryl, heteroarylalkyl, heteroarylalkenyl, heteroarylalkynyl,alkoxy, halo, mercapto, azido, cyano, formyl, carboxylic acid, hydroxyl,nitro, acyl, aryloxy, alkylthio, amino, alkylamino, arylalkylamino,disubstituted amino, acylamino, acyloxy, ester, amide, sulfoxyl,sulfonyl, sulfonate, sulfonic acid, sulfonamide, urea, alkoxylacylamino,and aminoacyloxy; or a pharmaceutically acceptable salt or prodrugthereof.
 30. The method of claim 29, wherein the compound is STO-609.31. The method of claim 1, wherein the method further comprisesadministering an effective amount of a second agent selected fromanti-androgens, Selective Androgen Receptor Modulators (SARMs),Selective Androgen Receptor Degraders (SARDs), CYP17 inhibitors,suphatase inhibitors, Src inhibitors, anti-estrogens, estrogens,Selective Estrogen Receptor Modulators (SERMs), Selective EstrogenReceptor Degraders (SERDs), ERb antagonists, aromatase inhibitors, and avaccine.
 32. The method of claim 31, wherein the second agent isselected from MDV3100, ARN-509, bicalutamide, and flutamide. 33-41.(canceled)
 42. A method of inhibiting proliferation of a prostate cancercell in a subject, the method comprising administering to the subject aneffective amount of an inhibitor of AMPK, AMPKα1 subunit, or AMPKα2subunit, or any combination thereof.
 43. The method of claim 42 whereinthe inhibitor is an inhibitory RNA.
 44. A method of determining theefficacy of therapy in a patient being treated for prostate cancer, themethod comprising: a) obtaining a series of samples from the subject; a)determining an amount of at least one of CaMKKβ, CaMKKβ splice variant2, CaMKKβ splice variant 7, phosphorylated AMPK, phosphorylated AMPKα1subunit, and phosphorylated AMPKα2 subunit in the series of samples fromthe subject, where the samples are taken from the subject at differenttime points during the therapy; and b) comparing the amount of at leastone of CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splice variant 7,phosphorylated AMPK, phosphorylated AMPKα1 subunit, and phosphorylatedAMPKα2 from the series of samples from the subject; wherein when theamount of at least one of CaMKKβ, CaMKKβ splice variant 2, CaMKKβ splicevariant 7, phosphorylated AMPK, phosphorylated AMPKα1 subunit, andphosphorylated AMPKα2 in the series of samples is about the same orincreases the therapy is determined to be not effective. 45-47.(canceled)
 48. A nucleic acid molecule comprising a sequence that bindsunder stringent conditions to a region that is about 2.3 kb upstream(5′) relative to a CaMKKβtranscriptional start site.
 49. The nucleicacid molecule of claim 48 wherein the region is from about −2231 toabout −1632 upstream (5′) relative to a CaMKKβ transcriptional startsite.
 50. The nucleic acid molecule of claim 48 wherein the region isfrom about −2019 to about −1632 upstream (5′) relative to a CaMKKβtranscriptional start site.
 51. The nucleic acid molecule of claim 50comprising the sequence 5′-GTA ACA TGA TGT AAA-3′.
 52. The nucleic acidmolecule of claim 48, wherein the nucleic acid molecule is selected fromdecoy RNA, dsRNA, a nucleic acid aptamer, an antisense nucleic acidmolecule, and an enzymatic nucleic acid molecule.
 53. A nucleic acidmolecule comprising a double stranded siRNA that down-regulatesexpression of a CaMKKβ gene via RNA interference (RNAi), wherein: a)each strand of the siRNA molecule is independently about 18 to about 28nucleotides in length; and b) one strand of the siRNA molecule comprisesa sequence that binds under stringent conditions to a CaMKKβ RNA of theCaMKKβ gene and directs cleavage of the CaMKKβ RNA via RNA interference.54. The nucleic acid molecule of claim 53 comprising the siRNA sequencesof SEQ ID NOs. 105-113.